Clinical features and outcomes of 2019 novel coronavirus-infected patients with high plasma brain natriuretic peptide levels

LIU De-hui; LI Jing-long; SONG Hua-feng; CHEN Chun-lin; LV Ming-fang; PEI Xing; LIU You-bin

摘要：Background As shown in previous studies,high brain natduretic peptide (BNP) is one of conunon abnormal laboratory test results in some critical patients infected with 2019 novel coronavirus (2019-nCoV),while the role of BNP in the prognosis of coronavirus disease 2019 (COVID-19) is still unknown.This study aims to investigate the effects of the increased BNP value on the outcomes of 2019-nCoV infected patients.Methods Our study initially included patients diagnosed with COVID-19 in Guangzhou Eighth People's Hospital from January 20th,2020 to February 24th.After screening out the participants based on the exclusion criteria,a total of 34 participants were finally enrolled in our research for retrospective analysis.The primary outcome was severe pneumonia defined according to the international guidelines for community-acquired pneumonia.Clinical characteristics and laboratory data were collected from their medical records.Results The best cut-off value of BNP for predicting severe pneumonia was 97.5 pg/mL with the sensitivity for 80％ and the specificity for 91.7％.The median age for high BNP level group (＞97.5 pg/mL) was 60.5 years (interquartile range: 40-80 years).The ratio of males in those patients was 60.0％.Compared with the normal BNP level group,higher temperature (P=0.09),higher values of aspartate aminotransferase (P=0.02),troponin I (P＜0.001),C-reactive protein (P＜0.001) and myoglobin (P=0.001) as well as lower levels of hemoglobin (P=0.04) and platelet count (P=0.001) were observed in the high BNP group.Multivariable logistic regression demonstrated that 2019-nCoV infected patients with high BNP were more likely to develop severe pneumonia (OR: 17.368,P=0.025) and be admitted to the intensive care unit (OR: 27.093,P=0.048).Conclusions The increased level of BNP is associated with the undesirable condition and disease aggravation of patients with COVID-19.BNP is expected to be an independent prognostic predictor of clinical outcomes for patients with COVID-19.