Department of Biochemistry, AIIMS Bhopal, Saket Nagar, Bhopal, India.
Independent Researcher, India.
Curr Cardiol Rev. 2022;18(4):e220222201354. doi: 10.2174/1573403X18666220222144002.
With the incidence of the unabated spreading of the COVID-19 (coronavirus disease 2019) pandemic with an increase in heart-related complications in COVID-19 patients, laboratory investigations on general health and diseases of heart have greater importance. The production of a higher level of clots in the blood in COVID-19 individuals carries a high risk of severe lethal pneumonia, pulmonary embolism, or widespread thromboembolism. The COVID-19 pandemic has raised awareness regarding the severe consequences for the cardiac system that might cause due to severe acute respiratory distress syndrome (SARS-CoV-2). COVID-19 causes acute respiratory distress syndrome (ARDS), acute myocardial infarction, venous thromboembolism, and acute heart failure in people with preexisting cardiac illness. However, as COVID-19 is primarily a respiratory infectious disease, there is still a lot of debate on whether and how cardiac biomarkers should be used in COVID-19 patients. Considering the most practical elucidation of cardiac biomarkers in COVID-19, it is important to note that recent findings on the prognostic role of cardiac biomarkers in COVID-19 patients are similar to those found in pneumonia and ARDS studies. The use of natriuretic peptides and cardiac troponin concentrations as quantitative variables should help with COVID-19/pneumonia risk classification and ensure that these biomarkers sustain their high diagnostic precision for acute myocardial infarction and heart failure. Serial assessment of D-dimers will possibly aid clinicians in the assortment of patients for venous thromboembolism imaging in addition to the increase of anticoagulation from preventive to marginally higher or even therapeutic dosages because of the central involvement of endothelitis and thromboembolism in COVID-19. Therefore, cardiac biomarkers are produced in this phase because of some pathological processes; this review will focus on major cardiac biomarkers and their significant role in COVID-19.
随着 COVID-19（2019 年冠状病毒病）大流行的持续蔓延，COVID-19 患者的心脏相关并发症不断增加，因此对一般健康和心脏疾病的实验室检查显得尤为重要。COVID-19 患者血液中血栓的产生水平较高，这会大大增加其发生严重致死性肺炎、肺栓塞或广泛血栓栓塞的风险。COVID-19 大流行使人们认识到，严重急性呼吸窘迫综合征（SARS-CoV-2）可能会对心脏系统造成严重后果。COVID-19 可引起患有潜在心脏疾病的人群出现急性呼吸窘迫综合征（ARDS）、急性心肌梗死、静脉血栓栓塞和急性心力衰竭。然而，由于 COVID-19 主要是一种呼吸道传染病，因此关于是否以及如何在 COVID-19 患者中使用心脏生物标志物仍然存在很多争议。考虑到心脏生物标志物在 COVID-19 中的最实际应用，重要的是要注意，最近关于心脏生物标志物在 COVID-19 患者中的预后作用的研究结果与肺炎和 ARDS 研究中的结果相似。将利钠肽和心脏肌钙蛋白浓度作为定量变量使用，有助于对 COVID-19/肺炎风险进行分类，并确保这些标志物保持其对急性心肌梗死和心力衰竭的高诊断精度。连续评估 D-二聚体可能有助于临床医生在 COVID-19 中内皮炎症和血栓栓塞的中心作用之外，对患者进行静脉血栓栓塞成像的分类，增加抗凝药物的剂量，从预防性剂量提高到稍高剂量，甚至治疗性剂量。因此，在这个阶段由于某些病理过程会产生心脏生物标志物；本综述将重点介绍主要的心脏生物标志物及其在 COVID-19 中的重要作用。
