Plasma Coenzyme Q10 and NT-proBNP Levels in COVID-19 Patients and Their Relation to Occurrence of Subtle Cardiac Abnormalities Detected by Echocardiography

Abstract

Background: COVID-19 outbreak led to a series of acute atypical respiratory diseases. The host immune response to the corona virus “SARS-CoV-2” is considered a key determinant of disease pathogenesis and the resulting clinical outcomes. Coenzyme Q10 (CoQ10) is known for its role as a potent antioxidant in affected organs specially the cardiovascular system. We sought to investigate the early occurrence of cardiac abnormalities that may arise in severe COVID-19 infections by testing blood levels of CoQ10, N-terminal pro-brain natriuretic peptide (NT-proBNP) and performing conventional transthoracic echocardiography.
Subjects and methods: Subjects were categorized into three groups. Group “1”: 30 COVID-19 cases requiring intensive care unit (ICU) admission, group “2”: 30 mild COVID-19 home-isolated cases and group “3”: 30 healthy age and sex matched controls. All subjects were tested for CoQ10 and NT-proBNP blood levels as well as conventional transthoracic echocardiography.
Results: There was statistical significance between the three study groups regarding ejection fraction (EF), tricuspid annular plane systolic excursion (TAPSE) and NT-proBNP (p-value: <0.001, 0.001 and <0.001 respectively). CoQ10 level was not significantly different between the three study groups (p-value: 0.496). A cut-off of 960.9 μg/L NT-proBNP is desired to predict the likeliness of ICU admission in COVID-19 patients with sensitivity 73% and specificity 90%. There was a weak negative correlation between CoQ10 and interleukin-6 (r-value: -0.391 and p-value: 0.032).
Conclusion: Subtle cardiac abnormalities that may happen as a result of severe COVID-19 infection can be detected by measuring blood levels of NT-proBNP and performing an echocardiography as a screening tool to all ICU-admitted COVID-19 patients. However, it is not recommended to measure plasma levels of CoQ10 in COVID-19 patients.