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?:abstract
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BACKGROUND: Coronavirus disease 2019 (COVID-19) has been widespread since late December 2019, with several symptoms related to the upper and lower respiratory system However, its cardiac manifestations are less frequently studied We aimed to analyze the available COVID-19 data on acute cardiac injury, using troponin and brain natriuretic peptide (BNP) levels METHODS: We performed a systematic review on Medline/PubMed, Scopus, and Google Scholar databases until March 25, 2020 Relevant records reporting the incidence of acute cardiac injury as well as troponin and BNP levels were collected from published peer-reviewed articles with further analysis according to the clinical status of the patients (severe, non-severe, and death) RESULTS: Eleven records of 1394 individuals were included The mean age of patients with acute cardiac injury was 56 6 ± 33 4 years (males: 54 3%) The incidence of acute cardiac injury was 15% (95% CI: 11, 20%) Further analysis revealed that dead or severe patients had significantly higher percentages of myocardial injury, compared to non-severe ones (peer-reviewed: 44%, 95% CI: 16, 74% vs 24%, 95% CI: 15, 34% vs 5%, 95% CI: 1, 12%, respectively) Mean total troponin was 10 23 pg/mL (95% CI: 5 98, 14 47), while 13% (95% CI: 8%, 18%) of patients had elevated levels Mean BNP was 216 74 pg/mL (95% CI: 3 27, 430 20) CONCLUSION: Acute cardiac injury in COVID-19 patients is more frequent than what was expected at the beginning of the outbreak Meanwhile, further studies are needed to investigate the utility of cardiac biomarkers as diagnostic and prognostic tools for long-term cardiac complications of this infection
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