Xinghuan Wang1*, Guang Zeng1, Jinpeng Li2, Xiaohui Wu3*, Qian Wu3, Yibin Yang4, Wen Zeng5, Sichao Chen6, Yihui Huang6, Danyang Chen6, Liang Guo6*, Qianqian Li6, Zeming Liu6
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.