High myoglobin level as an independent risk factor for death in patients with critical COVID-19 infection：A retrospective case-control study

Abstract

Aim This study aimed to discover risk factors for death in patients with critical COVID-19 infection in order to identify patients with a higher risk of death at an early stage. Methods We retrospectively analyzed the clinical data of patients with critical COVID-19 infection from April 2022 to June 2022. Data were collected from the electronic medical records. Propensity matching scores were used to reduce the effect of confounding factors, such as patient baseline variables. Independent risk factors affecting patient prognosis were assessed using univariate logistic regression and multivariate logistic regression analysis. Restricted cubic spline curves were used to assess the relationship between independent and dependent variables. Results The data of 137 patients with critical COVID-19 infection were collected. Of the 137 patients, 84 survived and 53 died. Among laboratory indicators, patients who died had higher proportions of abnormalities in RDW SD, procalcitonin, aspartate aminotransferase (AST), creatinine, potassium, cardiac troponin I, and myoglobin. Univariate and multivariate logistic regression analyses suggested that abnormal AST (OR = 3.26, P = 0.044), creatinine (OR = 4.49, P = 0.037), and myoglobin (OR = 9.88, P = 0.025) were independent risk factors for death. After correction for AST and creatinine, a linear relationship between myoglobin and risk of death in patients was found using restricted cubic splines. Conclusion High myoglobin level is an independent risk factor for death and is therefore a prognostic marker in patients with severe COVID-19 infection.