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. 2021 Sep 1:338:278-285.
doi: 10.1016/j.ijcard.2021.06.028. Epub 2021 Jun 19.

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

Alessandro Maino  1 , Enrico Di Stasio  2 , Maria Chiara Grimaldi  3 , Luigi Cappannoli  3 , Erica Rocco  3 , Rocco Vergallo  3 , Federico Biscetti  4 , Silvia Baroni  2 , Andrea Urbani  2 , Raffaele Landolfi  5 , Luigi Marzio Biasucci  6
Affiliations

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

Alessandro Maino et al. Int J Cardiol. .

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.

Keywords: COVID-19; Coronavirus; Heart failure; Myocardial injury; SARS-CoV-2; Troponin.

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Figures

Fig. 1
Fig. 1
Frequency of log10 HsTnI concentrations in the population under study. Dotted line represent the mean cut-off level (1.7 ng/L) for male (1.8 ng/L) and female (1.6 ng/L) subjects for myocardial injury.
Fig. 2
Fig. 2
Frequency of log10 HsTnI concentrations in the population under study for different clinical severity pictures.
Fig. 3
Fig. 3
Frequency of log10 HsTnI concentrations in the population under study for clinical outcome of death.
See this image and copyright information in PMC

Comment in

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