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Inpatient Utility of Pro-BNP in COVID-19: A Single Center Experience
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  • Saif Ali,
  • Shuktika Nandkeolyar,
  • Tanya Doctorian,
  • Payush Chatta,
  • Shaunrick Stoll,
  • Eunice Park,
  • Reece Stutzman,
  • Kristoff Foster,
  • Sharon Fabbri,
  • Dmitry Abramov,
  • Liset Stoletniy,
  • Antoine Sakr
Saif Ali
Loma Linda University Medical Center

Corresponding Author:[email protected]

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Shuktika Nandkeolyar
Loma Linda University Medical Center
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Tanya Doctorian
Loma Linda University Medical Center
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Payush Chatta
Loma Linda University Medical Center
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Shaunrick Stoll
Loma Linda University Medical Center
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Eunice Park
Loma Linda University Medical Center
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Reece Stutzman
Loma Linda University Medical Center
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Kristoff Foster
Loma Linda University Medical Center
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Sharon Fabbri
Loma Linda University Medical Center
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Dmitry Abramov
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Liset Stoletniy
Loma Linda University Medical Center
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Antoine Sakr
Loma Linda University Medical Center
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Abstract

Abstract: Aims: The purpose of this study was to identify serologic and clinical factors in SARS-Coronavirus 2 (SARS-CoV-2) patients which may correlate and predict need for mechanical ventilation and mortality. Furthermore, we sought to determine if a diagnosis of heart failure and elevations in Pro B-Type Natriuretic Peptide (pro-BNP) predicted clinical endpoints. Methods: 135 patients age 18 or older admitted to Loma Linda University Medical Center with SARS-Co-2 between March 16, 2020 and June 8, 2020 were categorized by demographic data (age, race, and gender), clinical parameters (temperature, heart rate, blood pressure, and peak fraction of inspired oxygen (FiO2)), and serologic markers pro-BNP. A regression analysis was done to correlate need for mechanical ventilation and mortality. Results: In univariate analysis, elevated pro-BNP correlated with need for mechanical ventilation (p=0.006) and mortality (p=0.001). In multivariate analysis, elevated pro-BNP was significantly associated with requiring intubation (OR 4.5, p=0.03). Each year of age (OR 1.08, p=0.006) and unit of BMI (OR= 1.05, p=0.03) were significantly associated with increased mortality. In patients without a diagnosis of heart failure, average pro-BNP was elevated (1141.66 ng/dL) however it did not correlate with need for intubation or mortality. Conclusions and clinical implications: Coronavirus disease-19 (COVID-19) is associated with increased mortality and worse clinical outcomes in patients with heart failure. Despite a lack of heart failure diagnosis, elevated markers such as NT-Pro-BNP have been associated with increased mortality in COVID-19 hospitalized patients. Although no clear ‘cut-off’ has been described, our study findings suggest elevated pro-BNP may be a useful marker for disease severity and respiratory complications of COVID-19 patients with possible cardiac involvement. Similar to other single center findings, our study demonstrates worsened clinical outcomes for patients with advanced age and elevated body-mass index.