Background Myocardial damage worsens the clinical course and prognosis of coronavirus disease 2019 (COVID-19) patients. High total bilirubin levels have been associated with a poor prognosis in COVID-19. This study aimed to investigate the predictive value of the total bilirubin level, a marker of heme oxygenase-1 enzyme activity, in determining myocarditis in patients with COVID-19. Results A total of 190 patients diagnosed with COVID-19 were enrolled in the study. The patients were divided into two groups based on their troponin positivity. The study group ( n = 95) consisted of patients with high troponin, and the control group ( n = 95) consisted of patients without high troponin levels. The D-dimer (727 [572–995] vs. 591 [440–790], p = 0.001), C-reactive protein (CRP) (30.0 [10–48] vs. 10.3 [5.8–15.9], p < 0.001), and total bilirubin (9.5 [8.2–12.1] vs. 7.0 [5.3–8.0], p < 0.001) levels were significantly higher in the study group. In multivariate analysis, CRP (odds ratio [OR]: 1.103; 95% confidence interval [CI]: 1.060–1.148; p < 0.001) and total bilirubin (OR: 1.612; 95% CI: 1.330–1.954; p < 0.001) levels were independent predictors of myocarditis in COVID-19. Conclusions Total bilirubin levels can be used as an early predictor of myocarditis in COVID-19 and can contribute to therapy management.
【저자키워드】 COVID-19, myocarditis, Bilirubin, microthrombi, 【초록키워드】 coronavirus disease, therapy, Prognosis, CRP, D-dimer, Clinical course, management, Patient, patients, marker, Analysis, Odds ratio, Predictive, C-reactive protein (CRP, total bilirubin level, control group, study group, total bilirubin, 95% confidence interval, poor prognosis, troponin levels, enzyme activity, Result, enrolled, can be used, contribute, significantly higher, two group, diagnosed with COVID-19, independent predictor, patients with COVID-19, the study group, 【제목키워드】 independent, patients with COVID-19,