Elevated Serum Creatine Kinase as an Independent Prognostic Factor forMortality in Hospitalized Patients with COVID-19
2021
Objective: We aimed to investigate the effect of serum Creatine Kinase (CK) levels on disease progression and
prognosis in coronavirus disease 2019 (COVID-19).
Methods: This was a retrospective study of 1751 COVID-19 patients at Leishenshan hospital in Wuhan, China.
All patients were grouped to normal and elevated CK groups. Univariate and multivariate Cox regression analyses
were performed to explore the relationship between mortality and CK levels. Univariate and multivariate logistic
regression analyses were performed to explore the relationship between disease severity and CK levels. Survival curves
were generated for normal and elevated CK groups. Fitting curves were performed to investigate the relationships
between the number of days in hospital and Computed Tomography (CT) score.
Results: Elevated CK patients had higher incidences of critical disease severity (P<0.001), death, and higher CT
score. There was an association between elevated CK levels and mortality on multivariate Cox regression analysis
(HR=7.31; 95% CI, 1.09-48.96; P=0.04). Elevated CK patients were more likely to have critical disease severity on
multivariate logistic regression analysis (OR=4.38; 95% CI, 1.16-16.49; P=0.029). Kaplan-Meier curves demonstrated
poor prognosis with elevated CK levels (P<0.001).
Conclusion: Elevated CK level was an independent risk factor of mortality in COVID-19 patients. Inpatients with
elevated CK had a higher risk for mortality, as well as critical severity condition compared with normal CK inpatients.
This may help clinicians make more targeted drug choices to treat COVID-19 patients.
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