Characterization of myocardial injury in a cohort of patients with SARS-CoV-2 infection
© 2021 Elsevier España, S.L.U. All rights reserved..
BACKGROUND: Myocardial injury has been identified as a common complication in patients with COVID-19. However, recent research has serious limitations, such as non-guideline definition of myocardial injury, heterogenicity of troponin sampling or very short-term follow-up. Using data from a large European cohort, we aimed to overcome these pitfalls and adequately characterize myocardial damage in COVID-19.
METHODS: Consecutive patients with confirmed SARS-CoV-2 infection and available high-sensitive troponin I (hs-TnI), from March 1st to April 20th, 2020 who completed at least 1-month follow-up or died, were studied.
RESULTS: A total of 918 patients (mean age 63.2 ± 15.5 years, 60.1% male) with a median follow-up of 57 (49-63) days were included. Of these, 190 (20.7%) fulfilled strict criteria for myocardial injury (21.1% chronic, 76.8% acute non-ischemic, 2.1% acute ischemic). Time from onset of symptoms to maximum hs-TnI was 11 (7-18) days. Thrombotic and bleeding events, arrhythmias, heart failure, need for mechanical ventilation and death were significantly more prevalent in patients with higher hs-TnI concentrations, even without fulfilling criteria for myocardial injury. hs-TnI was identified as an independent predictor of mortality [HR 2.52 (1.57-4.04) per 5-logarithmic units increment] after adjusting for multiple relevant covariates.
CONCLUSION: Elevated hs-TnI is highly prevalent among patients with SARS-CoV-2 infection. Even mild elevations well below the 99th URL were significantly associated with higher rates of cardiac and non-cardiac complications, and higher mortality. Future research should address the role of serial hs-TnI assessment to improve COVID-19 prognostic stratification and clinical outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:157 |
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| Enthalten in: |
Medicina clinica (English ed.) - 157(2021), 6 vom: 24. Sept., Seite 274-280 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Caro-Codón, Juan [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Revised 18.09.2023 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.medcle.2021.02.008 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM331102145 |
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| 100 | 1 | |a Caro-Codón, Juan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Characterization of myocardial injury in a cohort of patients with SARS-CoV-2 infection |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Revised 18.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2021 Elsevier España, S.L.U. All rights reserved. | ||
| 520 | |a BACKGROUND: Myocardial injury has been identified as a common complication in patients with COVID-19. However, recent research has serious limitations, such as non-guideline definition of myocardial injury, heterogenicity of troponin sampling or very short-term follow-up. Using data from a large European cohort, we aimed to overcome these pitfalls and adequately characterize myocardial damage in COVID-19 | ||
| 520 | |a METHODS: Consecutive patients with confirmed SARS-CoV-2 infection and available high-sensitive troponin I (hs-TnI), from March 1st to April 20th, 2020 who completed at least 1-month follow-up or died, were studied | ||
| 520 | |a RESULTS: A total of 918 patients (mean age 63.2 ± 15.5 years, 60.1% male) with a median follow-up of 57 (49-63) days were included. Of these, 190 (20.7%) fulfilled strict criteria for myocardial injury (21.1% chronic, 76.8% acute non-ischemic, 2.1% acute ischemic). Time from onset of symptoms to maximum hs-TnI was 11 (7-18) days. Thrombotic and bleeding events, arrhythmias, heart failure, need for mechanical ventilation and death were significantly more prevalent in patients with higher hs-TnI concentrations, even without fulfilling criteria for myocardial injury. hs-TnI was identified as an independent predictor of mortality [HR 2.52 (1.57-4.04) per 5-logarithmic units increment] after adjusting for multiple relevant covariates | ||
| 520 | |a CONCLUSION: Elevated hs-TnI is highly prevalent among patients with SARS-CoV-2 infection. Even mild elevations well below the 99th URL were significantly associated with higher rates of cardiac and non-cardiac complications, and higher mortality. Future research should address the role of serial hs-TnI assessment to improve COVID-19 prognostic stratification and clinical outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Myocardial damage | |
| 650 | 4 | |a Outcomes | |
| 650 | 4 | |a Prognosis | |
| 650 | 4 | |a Troponin | |
| 700 | 1 | |a Rey, Juan R |e verfasserin |4 aut | |
| 700 | 1 | |a Buño, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Iniesta, Angel M |e verfasserin |4 aut | |
| 700 | 1 | |a Rosillo, Sandra O |e verfasserin |4 aut | |
| 700 | 1 | |a Castrejon-Castrejon, Sergio |e verfasserin |4 aut | |
| 700 | 1 | |a Merino, Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Marco, Irene |e verfasserin |4 aut | |
| 700 | 1 | |a Martinez, Luis A |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia-Veas, Jose M |e verfasserin |4 aut | |
| 700 | 1 | |a Martin-Polo, Lorena |e verfasserin |4 aut | |
| 700 | 1 | |a Rodriguez-Sotelo, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Martinez-Cossiani, Marcel |e verfasserin |4 aut | |
| 700 | 1 | |a Gonzalez-Valle, Luis |e verfasserin |4 aut | |
| 700 | 1 | |a Herrero, Alicia |e verfasserin |4 aut | |
| 700 | 1 | |a López-de-Sá, Esteban |e verfasserin |4 aut | |
| 700 | 1 | |a Merino, Jose L |e verfasserin |4 aut | |
| 700 | 0 | |a CARD-COVID Investigators |e verfasserin |4 aut | |
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