Study on Evaluation of Serum Cardiac Marker and Ferritin Levels in COVID 19 Patients
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Abstract
Background: COVID 19 pandemic is a systemic inflammatory condition caused by novel severe acute respiratory syndrome (SARS)CoV 2 virus infecting humans. The role of pro inflammatory cytokines such as interleukin (IL) 6, IL 12, IL 8 and tumour necrosis factor alpha causing dysfunctional immune response during the disease progression leads to acute respiratory distress syndrome and systemic organ failure. Ferritin is linked with COVID as a feature of respiratory oxidative stress (ROS) generation and secondary tissue damage. On the other side NTproBNP (N terminal pro brain natriuretic peptide) a heart failure marker also carries prognostic value in noncardiac conditions such as lung disease like in chronic obstructive pulmonary disease. However, its role in patients with COVID-19 and its prognostic value is still not well-established. Also, the relationship of ferritin an inflammatory marker with NTproBNP released in widespread alveolar damage or multi‑organ failure, and eventually death is not available widely.
Aim: The aim of the study is to evaluate the possible association between the N-terminal pro-brain type natriuretic peptide (NT-proBNP) levels and ferritin as a prognostic or diagnostic marker in COVID19 cases.
Methods and Material: This is a institutional record based cross sectional study, collected from records of patients admitted over a period of 4 months (July 2020-October 2020) at Jayadeva Institute of Cardiac sciences, Bengaluru, Karnataka, India. A total of 100 covid-19 patients were selected as per convenient sampling with CI-95% from the MRD case chart. Descriptive statistical analysis of data was done. Categorical variables such as age and gender were presented in (n)%. Continuous variables were expressed as mean±SD. ANOVA test was used to compare the parameters between quartiles (Q1- Q4) of Ferritin, p<0.05 was considered to be statistically significant. Pearson’s correlation coefficient was applied to analyse the correlation between study variables. The p-value <0.05 was considered statistically significant.
Results: The Random Blood glucose (RBG) was 117±60 which is on a higher range. Age is positively correlated with ferritin though minimal with r value 0.26 with p<0.01. Correlation with NTproBNP and age was r value 0.13 with p 0.19 with no statistical significance. Correlation between ferritin and NTproBNP was statistically significant with r value 0.56 with p <0.001. Analysis of variance across the quartiles was statistically significant for NTproBNP with p0.04, the other being close with p<0.06 however the other variables didn’t show statistical significance.
Conclusions: From the current study we conclude that serum NT pro BNP levels could be a marker of increasing severity of disease as it is seen with increasing quartiles of ferritin. A positive relationship exists between them Hence the cardiac stress marker elevated with inflammatory marker ferritin shows that both can be routinely used as a prognostic marker of COVID-19 or one can act as a surrogate marker for other in resource deficient conditions.
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