tetano
Editor, Senior Moderator
Sci Rep
. 2021 Mar 22;11(1):6515.
doi: 10.1038/s41598-021-85646-z.
The relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome
Alessandro Mengozzi[SUP] #[/SUP][SUP] 1 [/SUP], Georgios Georgiopoulos[SUP] #[/SUP][SUP] 2 3 [/SUP], Marco Falcone[SUP] 4 [/SUP], Giusy Tiseo[SUP] 4 [/SUP], Nicola Riccardo Pugliese[SUP] 4 [/SUP], Meletios A Dimopoulos[SUP] 3 [/SUP], Lorenzo Ghiadoni[SUP] 4 [/SUP], Greta Barbieri[SUP] 4 [/SUP], Francesco Forfori[SUP] 5 [/SUP], Laura Carrozzi[SUP] 6 [/SUP], Massimo Santini[SUP] 7 [/SUP], Fabio Monzani[SUP] 4 [/SUP], Salvatore De Marco[SUP] 8 [/SUP], Francesco Menichetti[SUP] 4 [/SUP], Agostino Virdis[SUP] #[/SUP][SUP] 4 [/SUP], Stefano Masi[SUP] #[/SUP][SUP] 4 9 [/SUP], Pisa Covid Study Group
Collaborators, Affiliations
Abstract
High sensitivity troponin T (hsTnT) is a strong predictor of adverse outcome during SARS-CoV-2 infection. However, its determinants remain partially unknown. We aimed to assess the relationship between severity of inflammatory response/coagulation abnormalities and hsTnT in Coronavirus Disease 2019 (COVID-19). We then explored the relevance of these pathways in defining mortality and complications risk and the potential effects of the treatments to attenuate such risk. In this single-center, prospective, observational study we enrolled 266 consecutive patients hospitalized for SARS-CoV-2 pneumonia. Primary endpoint was in-hospital COVID-19 mortality. hsTnT, even after adjustment for confounders, was associated with mortality. D-dimer and CRP presented stronger associations with hsTnT than PaO[SUB]2[/SUB]. Changes of hsTnT, D-dimer and CRP were related; but only D-dimer was associated with mortality. Moreover, low molecular weight heparin showed attenuation of the mortality in the whole population, particularly in subjects with higher hsTnT. D-dimer possessed a strong relationship with hsTnT and mortality. Anticoagulation treatment showed greater benefits with regard to mortality. These findings suggest a major role of SARS-CoV-2 coagulopathy in hsTnT elevation and its related mortality in COVID-19. A better understanding of the mechanisms related to COVID-19 might pave the way to therapy tailoring in these high-risk individuals.
. 2021 Mar 22;11(1):6515.
doi: 10.1038/s41598-021-85646-z.
The relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome
Alessandro Mengozzi[SUP] #[/SUP][SUP] 1 [/SUP], Georgios Georgiopoulos[SUP] #[/SUP][SUP] 2 3 [/SUP], Marco Falcone[SUP] 4 [/SUP], Giusy Tiseo[SUP] 4 [/SUP], Nicola Riccardo Pugliese[SUP] 4 [/SUP], Meletios A Dimopoulos[SUP] 3 [/SUP], Lorenzo Ghiadoni[SUP] 4 [/SUP], Greta Barbieri[SUP] 4 [/SUP], Francesco Forfori[SUP] 5 [/SUP], Laura Carrozzi[SUP] 6 [/SUP], Massimo Santini[SUP] 7 [/SUP], Fabio Monzani[SUP] 4 [/SUP], Salvatore De Marco[SUP] 8 [/SUP], Francesco Menichetti[SUP] 4 [/SUP], Agostino Virdis[SUP] #[/SUP][SUP] 4 [/SUP], Stefano Masi[SUP] #[/SUP][SUP] 4 9 [/SUP], Pisa Covid Study Group
Collaborators, Affiliations
- PMID: 33753759
- DOI: 10.1038/s41598-021-85646-z
Abstract
High sensitivity troponin T (hsTnT) is a strong predictor of adverse outcome during SARS-CoV-2 infection. However, its determinants remain partially unknown. We aimed to assess the relationship between severity of inflammatory response/coagulation abnormalities and hsTnT in Coronavirus Disease 2019 (COVID-19). We then explored the relevance of these pathways in defining mortality and complications risk and the potential effects of the treatments to attenuate such risk. In this single-center, prospective, observational study we enrolled 266 consecutive patients hospitalized for SARS-CoV-2 pneumonia. Primary endpoint was in-hospital COVID-19 mortality. hsTnT, even after adjustment for confounders, was associated with mortality. D-dimer and CRP presented stronger associations with hsTnT than PaO[SUB]2[/SUB]. Changes of hsTnT, D-dimer and CRP were related; but only D-dimer was associated with mortality. Moreover, low molecular weight heparin showed attenuation of the mortality in the whole population, particularly in subjects with higher hsTnT. D-dimer possessed a strong relationship with hsTnT and mortality. Anticoagulation treatment showed greater benefits with regard to mortality. These findings suggest a major role of SARS-CoV-2 coagulopathy in hsTnT elevation and its related mortality in COVID-19. A better understanding of the mechanisms related to COVID-19 might pave the way to therapy tailoring in these high-risk individuals.