?:abstract
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INTRODUCTION AND OBJECTIVES: COVID-19 is currently causing high mortality and morbidity worldwide Information on cardiac injury is scarce We aimed to evaluate cardiovascular damage in patients with COVID-19 and determine the correlation of high-sensitivity cardiac-specific troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) with the severity of COVID-19 METHODS: We included 872 consecutive patients with confirmed COVID-19 from February to April 2020 We tested 651 patients for high-sensitivity troponin T (hs-TnT) and 506 for NT-proBNP on admission Cardiac injury was defined as hs-TnT > 14ng/L, the upper 99th percentile Levels of NT-proBNP > 300 pg/mL were considered related to some extent of cardiac injury The primary composite endpoint was 30-day mortality or mechanical ventilation (MV) RESULTS: Cardiac injury by hs-TnT was observed in 34 6% of our COVID-19 patients Mortality or MV were higher in cardiac injury than noncardiac injury patients (39 1% vs 9 1%) Hs-TnT and NT-proBNP levels were independent predictors of death or MV (HR, 2 18;95%CI, 1 23-3 83 and 1 87 (95%CI, 1 05-3 36), respectively) and of mortality alone (HR, 2 91;95%CI, 1 211-7 04 and 5 47;95%CI, 2 10-14 26, respectively) NT-ProBNP significantly improved the troponin model discrimination of mortality or MV (C-index 0 83 to 0 84), and of mortality alone (C-index 0 85 to 0 87) CONCLUSIONS: Myocardial injury measured at admission was a common finding in patients with COVID-19 It reliably predicted the occurrence of mortality and need of MV, the most severe complications of the disease NT-proBNP improved the prognostic accuracy of hs-TnT
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