ABC | Volume 115, Nº2, August 2020

Brief Communication Martins-Filho et al. Cardiac biomarkers in patients with COVID-19 Arq Bras Cardiol. 2020; 115(2):273-277 guide the proper use of antiplatelet agents, anticoagulants, β -blockers, ACE inhibitors, and statins in this critical scenario, and we must adapt the current knowledge. 17 For instance, it has recently been suggested that renin-angiotensin- aldosterone system inhibitors could be deleterious or beneficial for patients with COVID-19, 18 but we lack definitive evidence for this decision. The findings of this study should be treated with caution. Its main limitations include the following: (1) Studies are limited to a single region and this has reduced our ability to verify possible population variability; (2) there was a moderate to high between-study heterogeneity, and (3) studies did not perform analysis for adjustment of confounding factors and their results were based on standard univariate models. Conclusions Th i s me t a - ana l y s i s con f i rms t ha t unde r l y i ng cardiovascular conditions, elevation of myocardial injury biomarkers during COVID-19 infection, and acute cardiovascular decompensation are predictors for mortality in SARS-CoV-2 infection. Further studies are needed to clarify potential mechanisms of cardiovascular injury and test appropriate treatments. Author contributions Conception and design of the research: Martins-Filho PR, Santos VS; Data acquisition and Statistical analysis: Martins- Filho PR; Analysis and interpretation of the data, Writing of the manuscript and Critical revision of themanuscript for intellectual content: Martins-Filho PR, Barreto-Filho JAS, Santos VS. Potential Conflict of Interest The authors report no conflict of interest concerning the materials and methods used in this study or the findings specified in this paper. Sources of Funding There was no external funding source for this study. 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