Prognostic value of cardiac troponins in case of COVID-19


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Abstract

Despite pulmonary tropism of SARS-CoV-2, COVID-19 has a very high risk of multiple organ failure development, including cardiovascular system damage. The possible mechanisms underlying myocardial injury in patients with COVID-19 are not fully understood, but are most likely multifactorial. Myocardial damage may be caused due to the direct effect of the virus on endothelial cells and cardiomyocytes, mediated by the angiotensin-converting enzyme 2 receptor. Myocardial involvement may also be due to the development of a «cytokine storm» and apoptosis of cardiomyocytes. Also, ischemic damage and even myocardial infarction can be the result of shock, hypoxia of various origins and prolonged tachycardia. Biomarkers of acute myocardial injury have shown their value as a laboratory prognostication tool in COVID-19 patients. Elevated serum troponin levels are correlated with health deterioration and increased mortality of patients with and without heart disease. Whether myocardial damage is the cause of the worsening of COVID-19 or a consequence of the progression of this disease is not completely clear, in our review we have only highlighted its possible mechanisms.

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About the authors

Amina M. Alieva

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

PhD in Medicine, associate professor of the Department of hospital therapy No. 2 of the Faculty of general medicine

Elena V. Reznik

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Email: elenaresnik@gmail.com
Dr. med. habil., professor, head of the Department of propaedeutics of internal diseases of the Faculty of general medicine

Natalia V. Teplova

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Dr. med. habil., professor, head of the Department of clinical pharmacology of the Faculty of general medicine

Maxim A. Batov

P.A. Herzen Moscow Scientific and Research Oncological Institute of Oncology - a branch of National Medical Research Center for Radiology

resident doctor

Lidia M. Shnahova

I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University)

doctor

Rosa A. Arakelyan

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

student at the Faculty of general medicine

Irina Evgenievna Baykova

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

PhD in Medicine, associate professor of the Department of hospital therapy No. 2 of the Faculty of general medicine

Gayane G. Totolyan

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

PhD in Medicine, associate professor of the Department of hospital therapy No. 2 of the Faculty of general medicine

Victoria M. Volynkina

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

PhD in Medicine, associate professor of the Department of hospital therapy No. 2 of the Faculty of general medicine

Vladimir A. Kislyakov

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Email: kvadoctor@mail.ru
PhD in Medicine, associate professor of the Department of hospital therapy No. 2 of the Faculty of general medicine

Igor G. Nikitin

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Dr. med. habil., professor, head of the Department of hospital therapy No. 2 of the Faculty of general medicine

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