Clin Chim Acta. 2020 Sep 30:S0009-8981(20)30468-X. doi: 10.1016/j.cca.2020.09.036. Online ahead of print.
BACKGROUND: Major cardiac complications have been described in SARS-CoV-2 patients. The study of cardiac troponin' kinetic release is the recommended approach to differentiate acute from chronic injury, in order to clinically manage different cardiac diseases.
AIM: To investigate whether serial measurements of high sensitivity troponin I (hs-cTnI) might provide additional information in SARS-CoV-2 patients's clinical management.
METHODS: 113 consecutive patients suffering from microbiology proven SARS-CoV2-infection have been studied. Hs-cTnI has been measured in lithium-heparin plasma samples using STAT High Sensitive Troponin I (Architect i2000, Abbott Diagnostics), being 99th percentiles 16 and 34 ng/L for females and males respectively.
RESULTS: In 69 out of 113 patients hs-cTnI has been measured, showing in 31 (45%) values higher than 99th percentiles in at least one occasion. In 50 patients (72%) a kinetic evaluation (at least 2 measurements during 24 h) has been carried out. Patients were subdivided into five groups: 1 (n=44) and 2 (n=19) no measurement of hs-cTnI or no monitoring respectively; 3 (n=15) no significant variations during monitoring; 4 (n=8) and 5 (n=27) significant variations with values persistently below or sometimes higher than 99th percentiles, respectively. Group 5 patients had a longer hospital stay (median 37 days, p=0.0001), a more aggressive disease (6 out of 27, 22%, died), more often need admission to ICU (n=25, 92.6%, p<0.0001), and show one or more peak values, sometime preceded by severe hypoxia.
CONCLUSIONS: In SARS-CoV-2 patients, hs-cTnI serial monitoring may provide additional data to stratify risk, establish prognosis and gaining epidemiological insight on cardiac involvement in this pandemic disease.