Cardiac Troponin Testing Strategies in COVID-19: From Acute Care to Long-Term Surveillance
Cardiac troponin emerged as an important prognostic indicator in hospitalized COVID-19 patients, though early pandemic publications generated uncertainty about reporting, interpretation, and pathophysiology. This review addresses SARS-CoV-2 cardiovascular effects, evaluates the strengths and limitations of troponin studies during the first pandemic wave, and recommends testing strategies spanning the acute phase through convalescence and long-term care. The authors identify critical gaps in understanding the relationship between myocardial injury and COVID-19 outcomes.
The original study
Cardiac Troponin Testing in Patients with COVID-19: A Strategy for Testing and Reporting Results.
- Authors
- Kavsak PA, Hammarsten O, Worster A, Smith SW, Apple FS
- Journal
- Clinical chemistry
- Type
- Journal Article, Research Support, Non-U.S. Gov't, Review
- PMID
- 33045044
Original abstract
BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged late in 2019 causing COVID-19 (coronavirus disease-2019) may adversely affect the cardiovascular system. Publications from Asia, Europe, and North America have identified cardiac troponin as an important prognostic indicator for patients hospitalized with COVID-19. We recognized from publications within the first 6 months of the pandemic that there has been much uncertainty on the reporting, interpretation, and pathophysiology of an increased cardiac troponin concentration in this setting. CONTENT: The purpose of this mini-review is: a) to review the pathophysiology of SARS-CoV-2 and the cardiovascular system, b) to overview the strengths and weaknesses of selected studies evaluating cardiac troponin in patients with COVID-19, and c) to recommend testing strategies in the acute period, in the convalescence period and in long-term care for patients who have become ill with COVID-19. SUMMARY: This review provides important educational information and identifies gaps in understanding the role of cardiac troponin and COVID-19. Future, properly designed studies will hopefully provide the much-needed evidence on the path forward in testing cardiac troponin in patients with COVID-19.