TY - JOUR
T1 - Cardiovascular biomarkers in patients with COVID-19
AU - Mueller, Christian
AU - Giannitsis, Evangelos
AU - Jaffe, Allan S
AU - Huber, Kurt
AU - Mair, Johannes
AU - Cullen, Louise
AU - Hammarsten, Ola
AU - Mills, Nicholas L
AU - Möckel, Martin
AU - Krychtiuk, Konstantin
AU - Thygesen, Kristian
AU - Lindahl, Bertil
AU - ESC Study Group on Biomarkers in Cardiology of the Acute Cardiovascular Care Association
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: [email protected].
PY - 2021/3/1
Y1 - 2021/3/1
N2 - The coronavirus disease 2019 (COVID-19) pandemic has increased awareness that severe acute respiratory distress syndrome coronavirus-2 (SARS-CoV-2) may have profound effects on the cardiovascular system. COVID-19 often affects patients with pre-existing cardiac disease, and may trigger acute respiratory distress syndrome (ARDS), venous thromboembolism (VTE), acute myocardial infarction (AMI), and acute heart failure (AHF). However, as COVID-19 is primarily a respiratory infectious disease, there remain substantial uncertainty and controversy whether and how cardiovascular biomarkers should be used in patients with suspected COVID-19. To help clinicians understand the possible value as well as the most appropriate interpretation of cardiovascular biomarkers in COVID-19, it is important to highlight that recent findings regarding the prognostic role of cardiovascular biomarkers in patients hospitalized with COVID-19 are similar to those obtained in studies for pneumonia and ARDS in general. Cardiovascular biomarkers reflecting pathophysiological processes involved in COVID-19/pneumonia and its complications have a role evaluating disease severity, cardiac involvement, and risk of death in COVID-19 as well as in pneumonias caused by other pathogens. First, cardiomyocyte injury, as quantified by cardiac troponin concentrations, and haemodynamic cardiac stress, as quantified by natriuretic peptide concentrations, may occur in COVID-19 as in other pneumonias. The level of those biomarkers correlates with disease severity and mortality. Interpretation of cardiac troponin and natriuretic peptide concentrations as quantitative variables may aid in risk stratification in COVID-19/pneumonia and also will ensure that these biomarkers maintain high diagnostic accuracy for AMI and AHF. Second, activated coagulation as quantified by D-dimers seems more prominent in COVID-19 as in other pneumonias. Due to the central role of endothelitis and VTE in COVID-19, serial measurements of D-dimers may help physicians in the selection of patients for VTE imaging and the intensification of the level of anticoagulation from prophylactic to slightly higher or even therapeutic doses.
AB - The coronavirus disease 2019 (COVID-19) pandemic has increased awareness that severe acute respiratory distress syndrome coronavirus-2 (SARS-CoV-2) may have profound effects on the cardiovascular system. COVID-19 often affects patients with pre-existing cardiac disease, and may trigger acute respiratory distress syndrome (ARDS), venous thromboembolism (VTE), acute myocardial infarction (AMI), and acute heart failure (AHF). However, as COVID-19 is primarily a respiratory infectious disease, there remain substantial uncertainty and controversy whether and how cardiovascular biomarkers should be used in patients with suspected COVID-19. To help clinicians understand the possible value as well as the most appropriate interpretation of cardiovascular biomarkers in COVID-19, it is important to highlight that recent findings regarding the prognostic role of cardiovascular biomarkers in patients hospitalized with COVID-19 are similar to those obtained in studies for pneumonia and ARDS in general. Cardiovascular biomarkers reflecting pathophysiological processes involved in COVID-19/pneumonia and its complications have a role evaluating disease severity, cardiac involvement, and risk of death in COVID-19 as well as in pneumonias caused by other pathogens. First, cardiomyocyte injury, as quantified by cardiac troponin concentrations, and haemodynamic cardiac stress, as quantified by natriuretic peptide concentrations, may occur in COVID-19 as in other pneumonias. The level of those biomarkers correlates with disease severity and mortality. Interpretation of cardiac troponin and natriuretic peptide concentrations as quantitative variables may aid in risk stratification in COVID-19/pneumonia and also will ensure that these biomarkers maintain high diagnostic accuracy for AMI and AHF. Second, activated coagulation as quantified by D-dimers seems more prominent in COVID-19 as in other pneumonias. Due to the central role of endothelitis and VTE in COVID-19, serial measurements of D-dimers may help physicians in the selection of patients for VTE imaging and the intensification of the level of anticoagulation from prophylactic to slightly higher or even therapeutic doses.
KW - Biomarkers
KW - CARDIAC TROPONIN
KW - COVID-19
KW - Cardiac troponin
KW - D-dimer
KW - NATRIURETIC PEPTIDE
KW - Natriuretic peptides
KW - RISK
KW - Risk prediction
KW - STROKE
KW - Pandemics
KW - Prognosis
KW - Comorbidity
KW - Humans
KW - Risk Factors
KW - Troponin/blood
KW - Cardiovascular Diseases/blood
KW - SARS-CoV-2
KW - COVID-19/epidemiology
KW - Biomarkers/blood
KW - Fibrin Fibrinogen Degradation Products/metabolism
UR - http://www.scopus.com/inward/record.url?scp=85108814043&partnerID=8YFLogxK
U2 - 10.1093/ehjacc/zuab009
DO - 10.1093/ehjacc/zuab009
M3 - Journal article
C2 - 33655301
SN - 2048-8726
VL - 10
SP - 310
EP - 319
JO - European Heart Journal: Acute Cardiovascular Care
JF - European Heart Journal: Acute Cardiovascular Care
IS - 3
ER -