Table 2
Creatine kinase-myocardial band (CK-MB) CK-MB is mostly found in the myocardium and is a diagnostic marker for myocardial damage[25], in fact it mainly exists in the outer plasma layer of myocardial cells, and is the most specific enzyme in the myocardial enzyme spectrum for clinical diagnosis of myocardial injury. It may have a prognostic value in COVID-19 infection because patients with high levels require urgent intervention and had poor prognosis[3], [21].
Elevated serum CK-MB, in fact, might indicate more organ damages and a higher immune response in patients with COVID-19, so additional monitoring should be conducted on these patients with abnormal serum CK-MB levels[26].
A meta-analysis of relation of CK-MB to risk of mortality in COVID-19[27], shown that patients with severe pneumonia have varying degrees of myocardial injury due to hypoxemia and toxicity of the pathogen[28], [29]. Furthermore, overall results showed that the elevated levels of CK- MB were significantly associated with an increased risk of the mortality in COVID-19 infected patients. Also a previous meta-analysis by Li et al[30] observed that the elevated CK-MB levels were associated with the severity of COVID-19 patients. Other Chinese studies showed patient with COVID-19 infection had high CK-MB levels associated with in-hospital death, compared to non-hospitalized patients[8], [10], [31], [32] (Table 3).