Niveles plasmáticos de troponina T y de la fracción aminoterminal del propéptido natriurético cerebral y su relación con mortalidad en COVID-19 / Troponin-T and n-terminal pro-brain type natriuretic peptide plasma levels and its relationship with mortality in COVID-19

Introducción: El compromiso cardiovascular en la enfermedad por coronavirus 2019 (COVID-19) no necesariamente se presenta con los síntomas clásicos descriptos en la miocarditis. Es creciente la evidencia que demuestra compromiso cardiovascular subclínico en contexto de la intensa inflamación desatada, la tormenta de citocinas involucradas, el estado protrombótico basal y la disfunción endotelial consecuente. Nos propusimos analizar si la troponina T (TT) y la fracción amino-terminal del propéptido natriurético cerebral (NT-proBNP) determinada al momento de ingreso hospitalario se relacionan con la mortalidad durante la internación de estos pacientes. Material y métodos: Estudio analítico, observacional, de cohortes retrospectivas y corte transversal. Incluyó sujetos con COVID-19 internados por enfermedad moderada-severa, del 20 de marzo de 2020 al 15 de noviembre de 2020. Se analizaron las determinaciones de TT y NT-proBNP obtenidas en las primeras 24 horas de ingreso. Se consideró TT alterada si ≥ 0,014 ng/dL y NT-proBNP alterado si ≥ 300 pg/mL. Resultados: Se incluyeron 108 sujetos, 63,2% hombres, edad 51,5 años (59-43). El 28% ingreso a Unidad de Cuidados Intensivos (UCI) y el 25% falleció. El grupo de pacientes con TT elevada presentó mayor mortalidad (OR = 3,1; IC 95% = 1,10-8,85; p = 0,028) al igual que el grupo con NT-proBNP elevado (OR = 3,47; IC 95% = 1,21-9,97; p = 0,017). Al análisis multivariado sólo NT-proBNP ≥300 pg/mL se mantuvo como factor de riesgo independiente. Conclusiones: Niveles de NT-proBNP ≥ 300 pg/mL al ingreso en pacientes con COVID-19 moderada-severa se relacionaron con una mayor mortalidad.(AU)

Introduction: Cardiovascular compromise in coronavirus disease 2019 (COVID-19) does not necessarily present with the classic symptoms described in myocarditis. There is growing evidence demonstrating subclinical cardiovascular compromise in the context of the intense inflammation unleashed, the cytokine storm involved, the baseline prothrombotic state, and the consequent endothelial dysfunction. We set out to analyse whether Troponin-T (TT) and the amino-terminal fraction of pro-brain natriuretic peptide (NT-proBNP) determined at hospital admission, are related to mortality during the hospitalization of these patients. Material and methods: Analytical, observational, retrospective cohort and cross-sectional study. It included subjects with COVID-19 hospitalized for moderate-severe illness, from 20/03/20 to 15/11/20. The TT and NT-proBNP obtained in the first 24 hours from admission were analysed. Altered TT was considered if ≥.014 ng/dl and altered NT-proBNP if ≥300 pg/ml. Results: One hundred and eight subjects were included, 63.2% men, age 51.5 years (59-43), 28% were admitted to the Critical Unit and 25% died. The group with elevated TT presented higher mortality (OR = 3.1; 95%CI = 1.10-8.85; p = .02). The group with elevated NT-proBNP also show higher mortality (OR = 3.47; 95%CI = 1.21-9.97; p = .01). On multivariate analysis, only NT-proBNP ≥300 pg/ml remained an independent risk factor. Conclusions: NT-proBNP levels ≥300 pg/ml at admission in patients with moderate-severe COVID-19 were associated with higher mortality.(AU)

[Troponin-T and n-terminal pro-brain type natriuretic peptide plasma levels and its relationship with mortality in COVID-19]. / Niveles plasmáticos de troponina T y de la fracción aminoterminal del propéptido natriurético cerebral y su relación con mortalidad en COVID-19.

INTRODUCTION: Cardiovascular compromise in coronavirus disease 2019 (COVID-19) does not necessarily present with the classic symptoms described in myocarditis. There is growing evidence demonstrating subclinical cardiovascular compromise in the context of the intense inflammation unleashed, the cytokine storm involved, the baseline prothrombotic state, and the consequent endothelial dysfunction. We set out to analyse whether Troponin-T (TT) and the amino-terminal fraction of pro-brain natriuretic peptide (NT-proBNP) determined at hospital admission, are related to mortality during the hospitalization of these patients. MATERIAL AND METHODS: Analytical, observational, retrospective cohort and cross-sectional study. It included subjects with COVID-19 hospitalized for moderate-severe illness, from 20/03/20 to 15/11/20. The TT and NT-proBNP obtained in the first 24 hours from admission were analysed. Altered TT was considered if ≥.014 ng/dl and altered NT-proBNP if ≥300 pg/ml. RESULTS: One hundred and eight subjects were included, 63.2% men, age 51.5 years (59-43), 28% were admitted to the Critical Unit and 25% died. The group with elevated TT presented higher mortality (OR = 3.1; 95%CI = 1.10-8.85; p = .02). The group with elevated NT-proBNP also show higher mortality (OR = 3.47; 95%CI = 1.21-9.97; p = .01). On multivariate analysis, only NT-proBNP ≥300 pg/ml remained an independent risk factor. CONCLUSIONS: NT-proBNP levels ≥300 pg/ml at admission in patients with moderate-severe COVID-19 were associated with higher mortality.