International Journal of Multidisciplinary Research and Explorer (IJMRE) March-2021 http://doi-ds.org/doilink/03.2021-25131145/IJMRE Website: www.ijmre.com Volume No.1, Issue. 4 37 EXPLORATION OF CARDIAC BIOMARKERS TO DECLINE MORTALITY IN COVID 19 PATIENTS Sonila Khan 1 , Rabia Yaqoob 2 , Zelle Humma 3 1 Student of MPhil Biochemistry, Department of Biochemistry and Biotechnology, Women University Multan, Pakistan 2 Student of MPhil Biochemistry, Department of Biochemistry and Biotechnology, Women University Multan, Pakistan 3 Assistant Professor at Department of Biochemistry and Biotechnology, Women University Multan, Pakistan 1sonilakhan789@gmail.com 2 tayyabchandia9994@gmail.com 3 hummabiochem@gmail.com Abstract— COVID 19 disease is caused by SARS CoV- 2 had been started from Wuhan, a city of China and affected hundreds of countries has no therapeutic agents known for the treatment. [2] The mortality rate of disease is high with the patients with pre-existing cardiovascular diseases. In some cases, COVID 19 is associated with induction of acute COVID 19 cardiovascular syndromes. The mortality risks of disease can be lessened by early detection of cardiovascular diseases and myocardial injuries by elevated level of cardiac biomarkers more specifically cardiac troponin I (cTnI) and B type natriuretic peptides (BNP)[4] and N terminal pro BNP NT pro BNP) [7]. Virus enters the cardiac cells by specific binding with spike proteins and caused increase destruction of myocardial cells and leading toward the release of specific cardiac troponin in the blood stream. Keywords—A disintegrin and metalloprotease 17, angiotensin converting enzyme 2, brain natriuretic peptides, cardiotropins, cardiovascular disease I. INTRODUCTION COVID 19 is the widespread disease that had affected the world, initiated from the Wuhan city of China in December 2019. [12] Corona virus disease 2019 (COVID) is caused by the SARS CoV-2 stands for severe acute respiratory syndrome coronavirus 2, spread of the disease had affected the world. [3,1,7] Similar type of disease originated in 2003- 2004 in China and then Saudi Arabia was MERS-CoV. [1] The patients affected by SARS CoV-2 with appearance of symptoms including fever, fatigue, cough, and pneumonia, organ disfunction in the first weak after infection.[4] In order to prevent the fatality of the disease COVID 19 should be detected at initial stages by using specific methods using reverse transcription polymerase chain reaction (RT-PCR). [6,9] Due to the severity of the disease various retrospective studies have been done on the COVID 19 patients indicated that along with the lung injury induced by COVID 19 level of cardiac biomarkers elevated. [1] This elevated level of cardiac biomarker is associated with high risk of mortality in COVID 19 cardiac patients. The condition become more severe due to poor prognosis of cardiovascular disease in COVID patients. SARS-CoV-19 infect the heart cell by different mechanisms result in permanent cardiomyocyte loss.[8] II. CARDIAC BIOMARKERS Cardiac biomarkers are said to be the specific biological analytes and elevated concentration of these biomarkers is detected in the blood stream of patient with cardiovascular disease. [2,4] Various biomarkers have been established in order to risk prediction tools in the diagnosis, treatment and research purposes. Glutamate oxaloacetic transaminase activity in serum is the earliest biomarker used since 1954. [10] These biomarkers include: 1. Cardiac troponin (cTn) 2. Suppression of tumorigenicity 2 (ST2) [1] 3. Brain natriuretic peptide (BNP) 4. NT pro BNP [3] 5. Myeloperoxidase (MPO) cytokines 6. Plasminogen activator-1 (PA-1) [8,12] 7. Galectin 3 (G3) [8] 8. Creatinine kinase MB and myoglobin 9. Ischemia modified albumin [3] 10. Arterial natriuretic peptides (ANP) 11. High sensitivity C reactive protein (hs-CRP) [9] 12. Growth differentiation factor-15 (GDF-15)