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

tetano

Editor, Senior Moderator
Int J Cardiol


. 2021 Jun 19;S0167-5273(21)01026-3.
doi: 10.1016/j.ijcard.2021.06.028. Online ahead of print.
Prevalence and characteristics of myocardial injury during COVID-19 pandemic: A new role for high-sensitive troponin


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



Affiliations

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 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 population 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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