Alterations in cardiac biomarkers have been reported in patients with coronavirus disease 2019 (COVID-19) in relation to disease severity and mortality. We conducted a systematic review and meta-analysis with meta-regression of studies reporting B-type natriuretic peptide (BNP) or N-terminal proBNP (NT-proBNP) plasma concentrations in COVID-19. We searched PubMed, Web of Science, and Scopus, between January 2020 and 2021, for studies reporting BNP/NT-proBNP concentrations, measures of COVID-19 severity, and survival status (PROSPERO registration number: CRD42021239190). Forty-four studies in 18,856 COVID-19 patients were included in the meta-analysis and meta-regression. In pooled results, BNP/NT-proBNP concentrations were significantly higher in patients with high severity or non-survivor status when compared to patients with low severity or survivor status during follow up (SMD = 1.07, 95% CI: 0.89–1.24, and p < 0.001). We observed extreme between-study heterogeneity ( I 2 = 93.9%, p < 0.001). In sensitivity analysis, the magnitude and the direction of the effect size were not substantially modified after sequentially removing individual studies and re-assessing the pooled estimates, (effect size range, 0.99 – 1.10). No publication bias was observed with the Begg's ( p = 0.26) and Egger's ( p = 0.40) t -tests. In meta-regression analysis, the SMD was significantly and positively associated with D-dimer ( t = 2.22, p = 0.03), myoglobin ( t = 2.40, p = 0.04), LDH ( t = 2.38, p = 0.02), and procalcitonin ( t = 2.56, p = 0.01) concentrations. Therefore, higher BNP/NT-proBNP plasma concentrations were significantly associated with severe disease and mortality in COVID-19 patients.
【저자키워드】 COVID-19, Biomarkers, Mortality, disease severity, B-type natriuretic peptide, 【초록키워드】 coronavirus disease, Meta-analysis, Biomarker, severity, COVID-19 severity, peptide, LDH, systematic review, D-dimer, procalcitonin, heterogeneity, meta-regression, survival, Patient, sensitivity analysis, estimates, NT-proBNP, COVID-19 patients, Myoglobin, BNP, Concentration, Analysis, severe disease, COVID-19 patient, plasma concentration, Web of Science, alteration, measure, effect size, survivor, N-terminal, SMD, concentrations, non-survivor, extreme, significantly, reported, conducted, searched, magnitude, significantly higher, Egger, 【제목키워드】 review, Natriuretic,