Prevalence and characteristics of myocardial injury during COVID-19 pandemic: A new role for high-sensitive troponin. (1st September 2021)

• Record Type: Journal Article
• Authors: Maino, Alessandro; Di Stasio, Enrico; Grimaldi, Maria Chiara; Cappannoli, Luigi; Rocco, Erica; Vergallo, Rocco; Biscetti, Federico; Baroni, Silvia; Urbani, Andrea; Landolfi, Raffaele; Biasucci, Luigi Marzio
• Is Part Of: International journal of cardiology. Volume 338(2021)
• Page Start: 278
• Page End: 285
• Publication Date: 2021-09-01
• Subjects: Myocardial injury -- Troponin -- Heart failure -- Coronavirus -- COVID-19 -- SARS-CoV-2; CE angiotensin-converting enzyme -- ACEi angiotensin-converting enzyme inhibitor -- AKI acute kidney injury -- ARB angiotensin II receptor blocker -- ARDS acute respiratory distress syndrome -- CMR cardiovascular magnetic resonance -- CKD chronic kidney disease -- COVID-19 coronavirus disease 2019 -- CRP C-reactive protein -- CVD cardiovascular disease -- Hs-Tn high sensitive troponin -- ICU intensive care unit -- MOF multiorgan failure -- MRA antimineralocorticoid -- SARS-CoV-2 severe acute respiratory syndrome coronavirus-2 -- WBC white blood cells; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2021.06.028
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: 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 hs-TnI 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. Highlights: Prevalence of myocardial injury in COVID-19 population is about 16%. Patients with myocardial injury were older and with more cardiovascular comorbidities. Multivariate analyses showed that high-sensitive troponin can predict the degree of COVID-19, intubation need and mortality. High-sensitive troponin (hs-Tn) can be a clinical tool in COVID-19 patients to triage them into distinct risk groups. Hs-Tn can play a pivotal role in the detection of subjects at high risk of both short- and long-term cardiac impairment.