The assessment of high sensitivity cardiac troponin in patients with COVID-19: A multicenter study
Marco Alfonso Perrone1,2, Federica Spolaore3, Massimiliano Ammirabile4
1Division of Cardiology, University of Rome Tor Vergata, Rome, Italy.
Insights
High sensitivity cardiac troponin T (hs-cTnT) assessment in COVID-19 patients can aid early diagnosis of myocardial injury. Elevated hs-cTnT levels correlate with severe symptoms, pre-existing cardiovascular conditions, and ICU admission.
Area of Science:
- Cardiology
- Infectious Diseases
- Biomarkers
Background:
- COVID-19 patients face increased mortality from cardiac complications, even without prior cardiovascular disease.
- Myocardial injury is a significant concern in COVID-19 patients.
Purpose of the Study:
- To assess high sensitivity cardiac troponin T (hs-cTnT) levels in COVID-19 patients.
- To evaluate the incidence of myocardial injury in this population.
Main Methods:
- A multicenter study involving 543 COVID-19 patients.
- Measurement of hs-cTnT to identify myocardial injury.
- Correlation analysis with patient demographics, symptoms, and disease course.
Main Results:
- 47.3% of patients had elevated hs-cTnT levels (>14 ng/L).
- High hs-cTnT correlated with fever, respiratory symptoms, pre-existing cardiovascular disease, hypertension, and ICU admission.
- 31.5% of patients without prior cardiovascular disease showed elevated hs-cTnT.
Conclusions:
- hs-cTnT assessment is valuable for early detection of cardiac involvement in COVID-19.
- Elevated hs-cTnT indicates a higher risk of severe outcomes.
Background:
Recent studies have shown that patients diagnosed with coronarivus disease 2019 (COVID-19) and also with previous cardiovascular diseases have a higher mortality due to worsening heart disease. At the same time, patients without previous cardiovascular disease may also have cardiac complications. The aim of this multicenter study was to assess high sensitivity cardiac troponin T (hs-cTnT) in patients with COVID-19 and to evaluate the incidence of myocardial injury.
Methods:
In this multicenter study we enrolled 543 patients, 57.8% males, median age 63 years (range 18-99) from three selected hospitals: University Hospital Tor Vergata in Rome, Fondazione IRCCS Ca 'Granda Ospedale Maggiore Policlinico, in Milan, S Chiara Hospital in Trento. We measured hs-cTnT in all patients to assess myocardial injury and correlations with patient's age, symptoms and disease course.
Results:
The data showed that, among the 543 patients studied, 257 patients (47.3%) had hs-cTnT values higher than the upper reference limit (URL) of 14 ng/L. Patients with high hs-cTnT had more frequently fever (p < 0.01) and respiratory symptoms (p < 0.01), compared to the group with hs-cTnT values below URL. The results showed also that patients with hs-cTnT above URL had a higher frequency of previous cardiovascular disease (p < 0.01) as well as of hypertension (p < 0.01). Instead, among 231 patients with no previous cardiovascular disease, 81 (31.5%) had hs-cTnT values above the URL. Finally. the majority of the patients with high hs-cTnT were admitted to the intensive care unit (p < 0.01).
Conclusion:
Our data suggest the assessment of high sensitivity cardiac troponin in patients with COVID-19 for early diagnosis of cardiac involvement.
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