Abstract
Coronavirus disease 2019 (COVID-19) has rapidly developed as a global health emergency. Respiratory diseases are significant causes of morbidity and mortality in these patients with a spectrum of different diseases, from asymptomatic subclinical infection to the progression of severe pneumonia and subsequent acute respiratory distress syndrome. Individuals with cardiovascular disease are more likely to become infected with SARS-CoV-2 and develop severe symptoms. Hence, patients with underlying cardiovascular disease mortality rate are over three times. Furthermore, note that patients with a history of cardiovascular disease are more likely to have higher cardiac biomarkers, especially cardiac troponins, than infected patients, especially those with severe disease, making these patients more susceptible to cardiac damage caused by SARS-2-CoV. Biomarkers are important in decision-making to facilitate the efficient allocation of resources. Viral replication in the heart muscle can lead to a cascade of inflammatory processes that lead to fibrosis and, ultimately, cardiac necrosis. Elevated troponin may indicate damage to the heart muscle and may predict death. After the first Chinese analysis, increased cardiac troponin value was observed in a significant proportion of patients, suggesting that myocardial damage is a possible pathogenic mechanism leading to severe disease and death. However, the prognostic performance of troponin and whether its value is affected by different comorbidities present in COVID-19 patients are not known. This review aimed to assess the diagnostic value of troponin to offer insight into pathophysiological mechanisms and reported new assessment methods, including new biosensors for troponin in patients with COVID-19.
Highlights
Coronavirus disease 2019 (COVID-19) is an emerging outbreak from Wuhan City, China, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Malik et al, 2020)
This study aimed to evaluate the diagnostic value of troponin to offer insight into pathophysiological mechanisms and reported new assessment methods, including new biosensors for troponin in patients with COVID-19
Additional biomarkers associated with SARS-CoV-2 that are related to severity and mortality include cardiovascular biomarkers, of which cardiac troponin is important (Zhou et al, 2020), or to the rate of chronic kidney diseases where a rise of creatinine amounts is detected in severe patients (Cheng et al, 2020)
Summary
Coronavirus disease 2019 (COVID-19) is an emerging outbreak from Wuhan City, China, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Malik et al, 2020). In 15% of infected patients, the clinical course of this pathology is complicated by the development of severe forms of interstitial pneumonia, which may lead to acute respiratory distress syndrome (ARDS), multi-organ failure (MOF), and death (Mattiuzzi and Lippi, 2020). Emerging literature has reported that 7%–28% of COVID-19 patients had developed an acute cardiac injury, eventually causing more complications and mortality (Wang et al, 2020a; Guo et al, 2020). Diagnosis of heart disease in these patients is possible by measuring cardiac troponin as the gold standard marker of myocardial damage (Park et al, 2017). Cardiac troponins have gradually gained greater clinical importance in the diagnosis, treatment, and prognosis of patients with cardiovascular disease (Park et al, 2017; Clerico et al, 2019). This study aimed to evaluate the diagnostic value of troponin to offer insight into pathophysiological mechanisms and reported new assessment methods, including new biosensors for troponin in patients with COVID-19
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