TY - JOUR
TI - The relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome
AU - Mengozzi, A.
AU - Georgiopoulos, G.
AU - Falcone, M.
AU - Tiseo, G.
AU - Pugliese, N.R.
AU - Dimopoulos, M.A.
AU - Ghiadoni, L.
AU - Barbieri, G.
AU - Forfori, F.
AU - Carrozzi, L.
AU - Santini, M.
AU - Monzani, F.
AU - De Marco, S.
AU - Menichetti, F.
AU - Virdis, A.
AU - Masi, S.
AU - Sabrina, A.D.I.
AU - Martina, B.
AU - Matteo, B.
AU - Elia, N.
AU - Stefano, S.
AU - Rachele, A.
AU - Valeria, C.
AU - Simone, P.
AU - Rubia, B.
AU - Pietro, B.
AU - Giulia, B.
AU - Francesco, C.
AU - Alessandra, D.R.
AU - Fabio, G.
AU - Paolo, M.
AU - Marco, M.
AU - Chiara, P.
AU - Alessandro, C.
AU - Francesco, C.
AU - Naria, P.
AU - Alessandro, C.
AU - Luciano, C.
AU - Chiara, S.
AU - Valentina, G.
AU - Uliana, M.
AU - Francesca, R.
AU - Giovanna, F.
AU - Maria, S.
AU - Pisa Covid Study Group
JO - Scientific Reports
PY - 2021
VL - 11
TODO - 1
SP - null
PB - Institute of Geographic Sciences and Natural Resources Research
SN - 2045-2322
TODO - 10.1038/s41598-021-85646-z
TODO - 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
TODO - 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).
ER -