The relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome
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 Dise...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-03-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-85646-z |
| _version_ | 1818749460564410368 |
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| author | Alessandro Mengozzi Georgios Georgiopoulos Marco Falcone Giusy Tiseo Nicola Riccardo Pugliese Meletios A. Dimopoulos Lorenzo Ghiadoni Greta Barbieri Francesco Forfori Laura Carrozzi Massimo Santini Fabio Monzani Salvatore De Marco Francesco Menichetti Agostino Virdis Stefano Masi Pisa Covid Study Group |
| author_facet | Alessandro Mengozzi Georgios Georgiopoulos Marco Falcone Giusy Tiseo Nicola Riccardo Pugliese Meletios A. Dimopoulos Lorenzo Ghiadoni Greta Barbieri Francesco Forfori Laura Carrozzi Massimo Santini Fabio Monzani Salvatore De Marco Francesco Menichetti Agostino Virdis Stefano Masi Pisa Covid Study Group |
| author_sort | Alessandro Mengozzi |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-18T04:04:08Z |
| format | Article |
| id | doaj.art-621ad0b8f2fd49f1886aac1074530b96 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-18T04:04:08Z |
| publishDate | 2021-03-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-621ad0b8f2fd49f1886aac1074530b962022-12-21T21:21:37ZengNature PortfolioScientific Reports2045-23222021-03-0111111110.1038/s41598-021-85646-zThe relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcomeAlessandro Mengozzi0Georgios Georgiopoulos1Marco Falcone2Giusy Tiseo3Nicola Riccardo Pugliese4Meletios A. Dimopoulos5Lorenzo Ghiadoni6Greta Barbieri7Francesco Forfori8Laura Carrozzi9Massimo Santini10Fabio Monzani11Salvatore De Marco12Francesco Menichetti13Agostino Virdis14Stefano Masi15Pisa Covid Study GroupDepartment of Clinical and Experimental Medicine, University of PisaSchool of Biomedical Engineering and Imaging Sciences, King’s College LondonDepartment of Clinical and Experimental Medicine, University of PisaDepartment of Clinical and Experimental Medicine, University of PisaDepartment of Clinical and Experimental Medicine, University of PisaDepartment of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of AthensDepartment of Clinical and Experimental Medicine, University of PisaDepartment of Clinical and Experimental Medicine, University of PisaDepartment of Anaesthesia and Intensive Care, University Hospital of PisaDepartment of Cardiothoracic and Vascular Department, University of PisaDepartment of Emergency Medicine, Azienda Ospedaliera Universitaria PisanaDepartment of Clinical and Experimental Medicine, University of PisaFifth Medical Unit, Azienda Ospedaliera Universitaria PisanaDepartment of Clinical and Experimental Medicine, University of PisaDepartment of Clinical and Experimental Medicine, University of PisaDepartment of Clinical and Experimental Medicine, University of PisaAbstract 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.https://doi.org/10.1038/s41598-021-85646-z |
| spellingShingle | Alessandro Mengozzi Georgios Georgiopoulos Marco Falcone Giusy Tiseo Nicola Riccardo Pugliese Meletios A. Dimopoulos Lorenzo Ghiadoni Greta Barbieri Francesco Forfori Laura Carrozzi Massimo Santini Fabio Monzani Salvatore De Marco Francesco Menichetti Agostino Virdis Stefano Masi Pisa Covid Study Group The relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome Scientific Reports |
| title | The relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome |
| title_full | The relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome |
| title_fullStr | The relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome |
| title_full_unstemmed | The relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome |
| title_short | The relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome |
| title_sort | relationship between cardiac injury inflammation and coagulation in predicting covid 19 outcome |
| url | https://doi.org/10.1038/s41598-021-85646-z |
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