Features of creatine-kinase in COVID-19 patients within various specific periods: A cohort study

Wan, S.; Qu, G.; Yu, H.; Zhu, H.; Huang, G.; Chen, L.; Zhang, M.; Liu, J.; Pei, B.

Background: Coronavirus disease 2019 (COVID-19) has been declared as a threat to the global. Due to the lack of efficient treatments, indicators were urgently needed during the evolvement of disease to analyze the illness and prognosis, and prevent the aggravation of COVID-19. Methods: Patients' general information, clinical type, all CK values and outcome were collected. CK value of all cases during disease course started from different initial time were analyzed. Results: All cases underwent 504 tests of CK since symptom onset and the median value was 51.7 (35.0-91.5) U/L. The first median value on the day 8 from exposure onset was 78.1 (69.1-85.8) U/L then showed an upward trend from the day 8 to the day 12 (reaching a peak of 279.3 U/L), finally showed a fluctuation decline after the day 12. The CK median value in critical cases reached the peak (625.5 U/L) on the transforming date, and then decreased rapidly to the normal range. Before death, the CK median value in dead cases firstly increased until the day -14 with a peak as 470.0 U/L, then decreased with fluctuation until day -2, and finally increased again on the day 0. Conclusions: CK reached its peak on the day when it became critical type, dynamic detection of CK can guide clinical judgment of prognosis. The increase of CK is a high risk factor of death. Severe cell damage 2 weeks before death might determines the outcome of the disease even if CK drops to the normal range afterward.