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...

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Autores principales:	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
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/621ad0b8f2fd49f1886aac1074530b96
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spelling	oai:doaj.org-article:621ad0b8f2fd49f1886aac1074530b962021-12-02T16:35:56ZThe relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome10.1038/s41598-021-85646-z2045-2322https://doaj.org/article/621ad0b8f2fd49f1886aac1074530b962021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-85646-zhttps://doaj.org/toc/2045-2322Abstract 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.Alessandro MengozziGeorgios GeorgiopoulosMarco FalconeGiusy TiseoNicola Riccardo PuglieseMeletios A. DimopoulosLorenzo GhiadoniGreta BarbieriFrancesco ForforiLaura CarrozziMassimo SantiniFabio MonzaniSalvatore De MarcoFrancesco MenichettiAgostino VirdisStefano MasiPisa Covid Study GroupNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q 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
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.
format	article
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
title	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_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_sort	relationship between cardiac injury, inflammation and coagulation in predicting covid-19 outcome
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/621ad0b8f2fd49f1886aac1074530b96
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The relationship between cardiac injury, inflammation and coagulation in predicting COVID-19 outcome

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