Cardiac biomarkers alterations in patients with SARS-CoV-2 infection

Abstract

Reliable biomarkers are necessary for the risk stratification of patients infected with SARS-CoV-2. This novel coronavirus is now established to affect several organs in addition to the lungs, most prominently the heart. This is achieved through direct damage to the myocardium and indirect immune-associated effects during the cytokine storm. We performed a literature review aiming to identify the prognostic value of alterations of cardiac biomarkers in SARS-CoV-2 infection. Cardiac biomarkers are significantly elevated in patients with severe COVID-19 and are independent predictors of mortality. High-sensitivity troponin I and T are correlated with multiple inflammatory indexes and poor outcomes. Although cut-off values have been established for most of cardiac biomarkers, lower limits for troponins may have better prognostic values and longitudinal monitoring of cardiac biomarkers can help the clinician assess the patient’s course. Additional measurements of NT-proBNP, can detect the subgroup of patients with poor prognosis.

Longwise Cluster Analysis for the Prediction of COVID-19 Severity within 72 h of Admission: COVID-DATA-SAVE-LIFES Cohort

“…Indeed, the liver health and coagulation axis appears as a relevant surrogate for elucidating some COVID-19 outcomes linked to systemic inflammation [ 43 ], as well as thrombotic and fibrinolytic disturbances [ 44 ], which were deciphered in the currently emerged three clusters, including some markers of global health such as lactate dehydrogenase or creatinine/urea measurements [ 45 ], as particularly discriminated in Cluster C. Interestingly, hemoglobin and prothrombin values evidenced divergent patterns after the following 72-h period, which represent a worth for a cluster monitor. Indeed, our results provide a tool in the early management of COVID-19 patients, in contrast to other related papers in COVID where it has been taken into account with cardiac biomarkers [ 46 ] or other more complex techniques, such as imaging-based prognosis or gene/protein expression [ 47 , 48 ].…”