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.

The relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome / Alessandro, Mengozzi; Georgios, Georgiopoulos; Falcone, Marco; Tiseo, Giusy; Nicola Riccardo Pugliese, ; Dimopoulos, Meletios A.; Lorenzo, Ghiadoni; Greta, Barbieri; Francesco, Forfori; Laura, Carrozzi; Massimo, Santini; Fabio, Monzani; Salvatore De Marco, ; Francesco, Menichetti; Agostino, Virdis; Stefano, Masi; Agostini Degl’Innocenti Sabrina, ; Biancalana, Martina; Borselli, Matteo; Nencini, Elia; Spinelli, Stefano; Antognoli, Rachele; Calsolario, Valeria; Paterni, Simone; Baldassarri, Rubia; Bertini, Pietro; Brizzi, Giulia; Corradi, Francesco; Della Rocca, Alessandra; Guarracino, Fabio; Malacarne, Paolo; Monfroni, Marco; Piagnani, Chiara; Celi, Alessandro; Cinotti, Francesco; Park, Naria; Cipriano, Alessandro; Colangelo, Luciano; Sonato, Chiara; Galfo, Valentina; Monica, Uliana; Ruberti, Francesca; Forotti, Giovanna; Sciuto, Mari. - In: SCIENTIFIC REPORTS. - ISSN 2045-2322. - 11:1(2021). [10.1038/s41598-021-85646-z]

The relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome

Marco Falcone;Giusy Tiseo;Bertini Pietro;Della Rocca Alessandra;Colangelo Luciano;Sonato Chiara;
2021

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
COVID-19; cardiac injury; inflammation
01 Pubblicazione su rivista::01a Articolo in rivista
The relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome / Alessandro, Mengozzi; Georgios, Georgiopoulos; Falcone, Marco; Tiseo, Giusy; Nicola Riccardo Pugliese, ; Dimopoulos, Meletios A.; Lorenzo, Ghiadoni; Greta, Barbieri; Francesco, Forfori; Laura, Carrozzi; Massimo, Santini; Fabio, Monzani; Salvatore De Marco, ; Francesco, Menichetti; Agostino, Virdis; Stefano, Masi; Agostini Degl’Innocenti Sabrina, ; Biancalana, Martina; Borselli, Matteo; Nencini, Elia; Spinelli, Stefano; Antognoli, Rachele; Calsolario, Valeria; Paterni, Simone; Baldassarri, Rubia; Bertini, Pietro; Brizzi, Giulia; Corradi, Francesco; Della Rocca, Alessandra; Guarracino, Fabio; Malacarne, Paolo; Monfroni, Marco; Piagnani, Chiara; Celi, Alessandro; Cinotti, Francesco; Park, Naria; Cipriano, Alessandro; Colangelo, Luciano; Sonato, Chiara; Galfo, Valentina; Monica, Uliana; Ruberti, Francesca; Forotti, Giovanna; Sciuto, Mari. - In: SCIENTIFIC REPORTS. - ISSN 2045-2322. - 11:1(2021). [10.1038/s41598-021-85646-z]
File allegati a questo prodotto
File Dimensione Formato  
Mengozzi_Relationship_2021.pdf

accesso aperto

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Creative commons
Dimensione 1.33 MB
Formato Adobe PDF
1.33 MB Adobe PDF

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1679946
Citazioni
  • ???jsp.display-item.citation.pmc??? 8
  • Scopus 10
  • ???jsp.display-item.citation.isi??? 10
social impact