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J Clin Med . B-Type Natriuretic Peptide as Biomarker of COVID-19 Disease Severity-A Meta-Analysis

tetano

Editor, Senior Moderator
J Clin Med


. 2020 Sep 12;9(9):E2957.
doi: 10.3390/jcm9092957.
B-Type Natriuretic Peptide as Biomarker of COVID-19 Disease Severity-A Meta-Analysis


Sabato Sorrentino[SUP] 1 [/SUP], Michele Cacia[SUP] 1 [/SUP], Isabella Leo[SUP] 1 [/SUP], Alberto Polimeni[SUP] 1 [/SUP], Jolanda Sabatino[SUP] 1 [/SUP], Carmen Anna Maria Spaccarotella[SUP] 1 [/SUP], Annalisa Mongiardo[SUP] 1 [/SUP], Salvatore De Rosa[SUP] 1 [/SUP], Ciro Indolfi[SUP] 1 2 [/SUP]



Affiliations

Abstract

Up to 15% of coronavirus disease 2019 (COVID-19) patients experience severe clinical presentation, resulting in acute respiratory distress (ARDS) and finally death. N-terminal natriuretic peptide (NT-proBNP) is associated with a worse prognosis in patients with ARDS. However, whether or not this peptide can help discriminate high-risk COVID-19 patients remains unclear. Therefore, in this meta-analysis, we summarized the available evidence on NT-proBNP in patients admitted for COVID-19. Pooled mean, mean differences (MD) and standardized mean difference (SMD) were the summary metrics. Thirteen studies were finally selected for this analysis with a total of 2248 patients, of which 507 had a severe condition (n = 240) or died (n = 267). Pooled mean NT-proBNP levels on admission were 790.57 pg/mL (95% confidence intervals (CIs): 532.50 to 1048.64) in patients that experienced a severe clinical condition or died, and 160.56 pg/mL (95% CI: 118.15 to 202.96) in non-severe patients (SMD: 1.05; 95% (CI): 0.83 to 1.28; p < 0.001; I[SUP]2[/SUP] 74%; and MD was 645.84 pg/mL (95% CI: 389.50-902.18). Results were consistent in studies categorizing patients as non-survivors versus survivors (SMD: 1.17; 95% CI 0.95 to 1.40; p < 0. 001; I[SUP]2[/SUP]: 51%), and in those classifying populations in severe versus non-severe clinical condition (SMD: 0.94 95% CI 0.56 to 1.32; p < 0.001; I[SUP]2[/SUP]: 81%; p[SUB]interaction[/SUB] = 0.30). In conclusion, our results suggest that assessing NT-proBNP may support physicians in discriminating high-risk COVID-19 patients.

Keywords: COVID-19; NT-proBNP; SARS-CoV-2; death.
 
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