@article{3056239,
    title = "The relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome",
    author = "Mengozzi, A. and Georgiopoulos, G. and Falcone, M. and Tiseo, G. and Pugliese, N.R. and Dimopoulos, M.A. and Ghiadoni, L. and Barbieri, G. and Forfori, F. and Carrozzi, L. and Santini, M. and Monzani, F. and De Marco, S. and Menichetti, F. and Virdis, A. and Masi, S. and Sabrina, A.D.I. and Martina, B. and Matteo, B. and Elia, N. and Stefano, S. and Rachele, A. and Valeria, C. and Simone, P. and Rubia, B. and Pietro, B. and Giulia, B. and Francesco, C. and Alessandra, D.R. and Fabio, G. and Paolo, M. and Marco, M. and Chiara, P. and Alessandro, C. and Francesco, C. and Naria, P. and Alessandro, C. and Luciano, C. and Chiara, S. and Valentina, G. and Uliana, M. and Francesca, R. and Giovanna, F. and Maria, S. and Pisa Covid Study Group",
    journal = "Scientific Reports",
    year = "2021",
    volume = "11",
    number = "1",
    publisher = "Institute of Geographic Sciences and Natural Resources Research",
    issn = "2045-2322",
    doi = "10.1038/s41598-021-85646-z",
    keywords = "C reactive protein;  fibrin degradation product;  fibrin fragment D;  low molecular weight heparin;  troponin T, blood;  blood clotting disorder;  complication;  female;  heart disease;  hemodynamics;  hospital mortality;  human;  inflammation;  isolation and purification;  Kaplan Meier method;  male;  middle aged;  mortality;  pathology;  prognosis;  prospective study;  risk;  virology, Blood Coagulation Disorders;  C-Reactive Protein;  COVID-19;  Female;  Fibrin Fibrinogen Degradation Products;  Heart Diseases;  Hemodynamics;  Heparin, Low-Molecular-Weight;  Hospital Mortality;  Humans;  Inflammation;  Kaplan-Meier Estimate;  Male;  Middle Aged;  Prognosis;  Prospective Studies;  Risk;  SARS-CoV-2;  Troponin T",
    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 PaO2. 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, The Author(s)."
}