Prevalence and characteristics of myocardial injury during COVID-19 pandemic: A new role for high-sensitive troponin

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:338

Article

Maino, Alessandro¹  Di Stasio, Enrico^2,3  Grimaldi, Maria Chiara¹  Cappannoli, Luigi¹  Rocco, Erica¹  Vergallo, Rocco¹  Biscetti, Federico^4,5  Baroni, Silvia^2,3  Urbani, Andrea^2,3  Landolfi, Raffaele^4,6  Biasucci, Luigi Marzio^1,7 

[1] Fdn Policlin Univ A Gemelli IRCCS, Dept Cardiovasc Sci, Rome, Italy

[2] Univ Cattolica Sacro Cuore, Clin Intensivol & Perioperatorie, Dipartimento Sci Biotecnol Base, Rome, Italy

[3] Fdn Policlin Univ A Gemelli IRCCS, UOC Chim Biochim & Biol Mol Clin, Dipartimento Sci Lab & Infettivol, Rome, Italy

[4] Catholic Univ, Sch Med, Fdn Policlin Univ A Gemelli IRCCS, UOC Clin Med & Malattie Vasc, Rome, Italy

[5] Univ Cattolica Sacro Cuore, Lab Vasc Biol & Genet, Rome, Italy

[6] Univ Cattolica Sacro Cuore, Div Internal Med, Rome, Italy

[7] Univ Cattolica Sacro Cuore, Dept Cardiovasc & Pulm Sci, Rome, Italy

关键词: Myocardial injury;    Troponin;    Heart failure;    Coronavirus;    COVID-19;    SARS-CoV-2;   

DOI  :  10.1016/j.ijcard.2021.06.028

来源: Elsevier

【 摘 要 】

Background: Coronavirus disease 2019 (COVID-19) is a pandemic disease that is causing a public health emergency. Characteristics and clinical significance of myocardial injury remain unclear. Methods: This retrospective single-center study analyzed 189 patients who received a COVID-19 diagnosis out of all 758 subjects with a high sensitive troponin I (Hs-TnI) measurement within the first 24 h of admission at the Policlinico A.Gemelli (Rome, Italy) between February 20th 2020 to April 09th 2020. Results: The prevalence of myocardial injury in our COVID-19 population is of 16%. The patients with cardiac injury were older, had a greater number of cardiovascular comorbidities and higher values of acute phase and inflammatory markers and leucocytes. They required more frequently hospitalization in Intensive Care Unit (10 [32.3%] vs 18 [11.4%]; p = .003) and the mortality rate was significantly higher (17 [54.8%] vs. 15 [9.5%], p < .001). Among patients in ICU, the subjects with myocardial injury showed an increase need of endotracheal intubation (8 out of 9 [88%] vs 7 out of 19[37%], p = .042). Multivariate analyses showed that hsTnI can significantly predict the degree of COVID-19 disease, the intubation need and in-hospital mortality. Conclusions: In this study we demonstrate that hs-Tn can significantly predict disease severity, intubation need and in-hospital death. Therefore, it may be reasonable to use Hs-Tn as a clinical tool in COVID-19 patients in order to triage them into different risk groups and can play a pivotal role in the detection of subjects at high risk of cardiac impairment during both the early and recovery stage. (c) 2021 Elsevier B.V. All rights reserved.

【 授权许可】

Free