Department of Internal Medicine, University Hospital of Patras, Greece.
Rom J Intern Med. 2022 Mar 17;60(1):6-13. doi: 10.2478/rjim-2021-0037. Print 2022 Mar 1.
Reliable biomarkers are necessary for the risk stratification of patients infected with SARS-CoV-2. This novel coronavirus is now established to affect several organs in addition to the lungs, most prominently the heart. This is achieved through direct damage to the myocardium and indirect immune-associated effects during the cytokine storm. We performed a literature review aiming to identify the prognostic value of alterations of cardiac biomarkers in SARS-CoV-2 infection. Cardiac biomarkers are significantly elevated in patients with severe COVID-19 and are independent predictors of mortality. High-sensitivity troponin I and T are correlated with multiple inflammatory indexes and poor outcomes. Although cut-off values have been established for most of cardiac biomarkers, lower limits for troponins may have better prognostic values and longitudinal monitoring of cardiac biomarkers can help the clinician assess the patient's course. Additional measurements of NT-proBNP, can detect the subgroup of patients with poor prognosis.
可靠的生物标志物对于感染 SARS-CoV-2 的患者的风险分层是必要的。这种新型冠状病毒现在已被确定除了肺部之外，还会影响多个器官，其中最突出的是心脏。这是通过在细胞因子风暴期间直接损伤心肌和间接免疫相关作用来实现的。我们进行了一项文献综述，旨在确定 SARS-CoV-2 感染中心脏生物标志物变化的预后价值。在重症 COVID-19 患者中，心脏生物标志物显著升高，是死亡率的独立预测因子。高敏肌钙蛋白 I 和 T 与多种炎症指标和不良结局相关。尽管大多数心脏生物标志物已经确定了截断值，但肌钙蛋白的下限可能具有更好的预后价值，并且心脏生物标志物的纵向监测可以帮助临床医生评估患者的病程。对 NT-proBNP 的进一步测量可以检测出预后不良的患者亚组。
