We noted significantly increased cTnI, CK, HBDB and LDH levels in very severe group as compare to severe (Table 1 ). We then applied Fisher's exact test to determine the positive rate of cardiac lesion markers between severe and very severe patients. Increasingly, the percentage of very severe patients with elevated cTnI levels was markedly higher, with 8/8 patients exhibiting increased cTnI in very severe group, and only 1/26 patient in severe group (P value<0.001). In addition, the abnormal percentage of HBDB and LDH showed no significant difference between 2 groups (Table 2 ).
Table 1 Baseline information and cardiac biomarkers in severe and very severe patients with COVID-19.
Median(IQR) P value Reference
Severe Very Severe
Number 26 8
Sex(Male%) 46.15% 62.50% ns
age 63(58–69) 67(66–75) ns
CRE(μmol/L) 64.2(56.5–74.7) 82.6(69.6–98.6) ns 57.0–111.0
AST(U/L) 32(25–45) 44(34–56) ns 8–40
ALT(U/L) 34(27–67) 49(29–75) ns 5–40
WBC count(*10^9/L) 5.93(4.77–7.45) 9.32(6.37–10.99) ns 3.50–9.50
NEU% 78.20(71.10–84.70) 86.70(63.50–91.15) ns 40.00–75.00
LYO% 14.30(11.90–18.90) 7.60(4.55–16.40) ns 20.00–50.00
CRP(mg/L) 18.87(12.26–43.66) 73.00(36.57–116.95) <0.05 0.00–8.00
Cardiac Biomarkers
cTnI(ng/L) 4.8(2.5–8.4) 46.8(34.2–299.8) <0.001 <26.2
Myo(ng/mL) 62.8(33.0–87.7) 101.75(59.4–212.4) ns <146.9
CK(U/L) 88(45–125) 199(77–285) <0.05 24–194
CKMB(U/L) 10(17–13) 13(10–25) ns 0–25
HBDB(U/L) 245(207–275) 453(347–547) <0.01 72–182
AST(U/L) 32(25–45) 44(34–56) ns 8–40
LDH(U/L) 287(246–331) 513(414–641) <0.01 109–245
Abbreviations: IQR: inter quartile range; CRE: Creatine; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; WBC: White blood count; NEU%: Neutrophil percentage; LYO%: Lymphocyte percentage; CRP: C reactive protein; cTnI: cardiac troponin I; Myo: myoglobin; CK: Creatine Kinase; CKMB: Creatine kinase–MB; HBDB: α-hydroxybutyrate dehydrogenase; AST: Aspartate aminotransferase; LDH: Lactate Dehydrogenase.
Table 2 Comparation of the severe and very severe patients with normal or elevated cardiac biomarkes.
Group Number cTnI (ng/L) CK (U/L) HBDB (U/L) LDH (U/L)
Normal Elevated Normal Elevated Normal Elevated Normal Elevated
Severe 26 25 1 23 3 4 22 6 20
Very Severe 8 0 8 4 4 0 8 0 8
P value <0.001 <0.05 ns ns
Abbreviations: cTnI: cardiac troponin I; CK: Creatine Kinase; HBDB: α-hydroxybutyrate dehydrogenase; LDH: Lactate Dehydrogenase.