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28.09.2020 | COVID-19 | IM - ORIGINAL Zur Zeit gratis

Incidence and determinants of high-sensitivity troponin and natriuretic peptides elevation at admission in hospitalized COVID-19 pneumonia patients

verfasst von: Luca Arcari, Michelangelo Luciani, Luca Cacciotti, Maria Beatrice Musumeci, Valerio Spuntarelli, Eleonora Pistella, Dario Martolini, Daniele Manzo, Mariateresa Pucci, Claudio Marone, Serena Melandri, Gerardo Ansalone, Claudio Santini, Paolo Martelletti, Massimo Volpe, Luciano De Biase

Erschienen in: Internal and Emergency Medicine | Ausgabe 8/2020

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Abstract

Background

Myocardial involvement in the course of coronavirus disease 2019 (COVID-19) pneumonia has been reported, though not fully characterized yet. The aim of the present study is to undertake a joint evaluation of hs-Troponin and natriuretic peptides (NP) in patients hospitalized for COVID-19 pneumonia.

Methods

In this multicenter observational study, we analyzed data from n = 111 patients. Cardiac biomarkers subgroups were identified according to values beyond reference range.

Results

Increased hs-Troponin and NP were found in 38 and 56% of the cases, respectively. As compared to those with normal cardiac biomarkers, these patients were older, had higher prevalence of cardiovascular diseases (CVD) and had more severe COVID-19 pneumonia by higher CRP and d-dimer and lower PaO2/FIO2. Two-dimensional echocardiography performed in a subset of patients (n = 24) showed significantly reduced left ventricular ejection fraction in patients with elevated NP (p = 0.02), whereas right ventricular systolic function (tricuspid annular plane systolic excursion) was significantly reduced both in patients with high hs-Troponin and NP (p = 0.022 and p = 0.03, respectively). Both hs-Troponin and NP were higher in patients with in-hospital mortality (p = 0.001 and p = 0.002, respectively). On multivariable analysis, independent associations were found of hs-Troponin with age, PaO2/FIO2 and d-dimer (B = 0.419, p = 0.001; B = − 0.212, p = 0.013; and B = 0.179, p = 0.037, respectively) and of NP with age and previous CVD (B = 0.480, p < 0.001; and B = 0.253, p = 0.001, respectively).

Conclusions

Myocardial involvement at admission is common in COVID-19 pneumonia. Independent associations of hs-Troponin with markers of disease severity and of NP with underlying CVD might point toward existing different mechanisms leading to their elevation in this setting.

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Titel: Incidence and determinants of high-sensitivity troponin and natriuretic peptides elevation at admission in hospitalized COVID-19 pneumonia patients
verfasst von: Luca Arcari
Michelangelo Luciani
Luca Cacciotti
Maria Beatrice Musumeci
Valerio Spuntarelli
Eleonora Pistella
Dario Martolini
Daniele Manzo
Mariateresa Pucci
Claudio Marone
Serena Melandri
Gerardo Ansalone
Claudio Santini
Paolo Martelletti
Massimo Volpe
Luciano De Biase
Publikationsdatum: 28.09.2020
Verlag: Springer International Publishing
Schlagwort: COVID-19
Erschienen in: Internal and Emergency Medicine / Ausgabe 8/2020
Print ISSN: 1828-0447
Elektronische ISSN: 1970-9366
DOI: https://doi.org/10.1007/s11739-020-02498-7

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