Περίληψη:
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).
Συγγραφείς:
Mengozzi, A.
Georgiopoulos, G.
Falcone, M.
Tiseo, G.
Pugliese, N.R.
Dimopoulos, M.A.
Ghiadoni, L.
Barbieri, G.
Forfori, F.
Carrozzi, L.
Santini, M.
Monzani, F.
De Marco, S.
Menichetti, F.
Virdis, A.
Masi, S.
Sabrina, A.D.I.
Martina, B.
Matteo, B.
Elia, N.
Stefano, S.
Rachele, A.
Valeria, C.
Simone, P.
Rubia, B.
Pietro, B.
Giulia, B.
Francesco, C.
Alessandra, D.R.
Fabio, G.
Paolo, M.
Marco, M.
Chiara, P.
Alessandro, C.
Francesco, C.
Naria, P.
Alessandro, C.
Luciano, C.
Chiara, S.
Valentina, G.
Uliana, M.
Francesca, R.
Giovanna, F.
Maria, S.
Pisa Covid Study Group
Λέξεις-κλειδιά:
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
