Piccioni A, Brigida M, Loria V, Zanza C, Longhitano Y, Zaccaria R, Racco S, Gasbarrini A, Ojetti V, Franceschi F, Candelli M
Emergency Department Fondazione Policlinico Universitario A. Gemelli, IRCSS, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2020 Oct;24(19):10293-10300. doi: 10.26355/eurrev_202010_23254.
Acute SARS-CoV-2 respiratory disease is an infectious respiratory disease caused by the virus SARS-CoV-2 belonging to the coronaviridae family. A pandemic is still present as of May 2020. In addition to causing pneumonia, SARS-CoV-2 may induce a direct damage to the heart, causing myocarditis, with significant impairment of cardiac contractility, and/or pericarditis. Elderly patients and those with cardiovascular risk factors, such as hypertension and diabetes mellitus, are at increased risk of heart complications from COVID-19. In this review, we focused on the correlation between COVID-19 infection and the high sensitivity troponin T and I, and their significance in the development of myocarditis. Data emerging from the studies so far conducted indicate that a high value of high-sensitivity troponin represents a negative prognostic indicator when associated with heart damage on an infectious-inflammatory basis (i.e. myopericarditis). We should identify a safe and clear diagnostic algorithm, possibly combining patient clinical history, troponin levels and cardiac ultrasound findings that could help us in the prediction of myopericarditis.
新型严重急性呼吸综合征冠状病毒（SARS-CoV-2）引起的急性呼吸道疾病是一种由属于冠状病毒科的SARS-CoV-2病毒引起的传染性呼吸道疾病。截至2020年5月，疫情仍在蔓延。除了引起肺炎外，SARS-CoV-2还可能对心脏造成直接损害，导致心肌炎，使心脏收缩力显著受损，和/或心包炎。老年患者以及患有心血管危险因素（如高血压和糖尿病）的患者患COVID-19心脏并发症的风险增加。在本综述中，我们重点关注了COVID-19感染与高敏肌钙蛋白T和I之间的相关性，以及它们在心肌炎发展中的意义。迄今为止进行的研究得出的数据表明，高敏肌钙蛋白值升高与基于感染性炎症（即心肌心包炎）的心脏损害相关时，是一个不良预后指标。我们应该确定一种安全、明确的诊断算法，可能需要结合患者的临床病史、肌钙蛋白水平和心脏超声检查结果，这有助于我们预测心肌心包炎。
