SIGNIFICANCE OF LABORATORY MARKERS IN COVID-19 ASSOCIATED MYOCARDITIS IN PREGNANT WOMEN
Keywords:
COVID-19; pregnancy; COVID-19 associated myocarditis; laboratory markers; troponin cTnI; NT-proBNPAbstract
Purpose: to assess the level of laboratory markers (troponin I and NT-proBNP) in pregnant women with COVID-19 associated myocarditis and their correlation with the severity of the disease. Methods. Based on the selection results, a group of 46 pregnant women was identified who were diagnosed with COVID-19 associated myocarditis based on the results of a comprehensive clinical, instrumental and laboratory study. During the study, all pregnant women underwent laboratory assessment of the level of troponin I (cTnI) and N-terminal B-type natriuretic peptide (NT-proBNP) in the blood. Results. An increase in cTnI was noted in 100% of cases. At the same time, the average value in the group was 12.4±6.3 ng/ml, which exceeds the reference value by 30 times. An increase in NT-proBNP was also noted in 100% of cases. The average value in the sample was 146.2±32.6 pg/ml. It should be noted that in most cases there was an increase in NT-proBNP >128 pg/ml. Conclusion. NT-proBNP in the blood is not only an indirect indicator of the presence of this pathology, but also a criterion for the severity of the condition, as well as a predictor of the development of severe complications in the cardiovascular system over time.
References
Atri D, Siddiqi HK, Lang JP, Nauffal V, Morrow DA, Bohula EA. COVID-19 for the cardiologist: basic virology, epidemiology, cardiac manifestations, and potential therapeutic strategies. JACC Basic Transl Sci 2020;5:518–36.
Babapoor-Farrokhran S, Gill D, Walker J, Rasekhi RT, Bozorgnia B, Amanullah A. Myocardial injury and COVID-19: possible mechanisms. Life Sci 2020;253:117723.
Bansal M. Cardiovascular disease and COVID-19. Diabetes Metab Syndr 2020;14: 247–50.
Chen H, Guo J, Wang C, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020;395:809–15.
Churchill TW, Bertrand PB, Bernard S, et al. Echocardiographic features of COVID-19 illness and association with cardiac biomarkers. J Am Soc Echocardiogr 2020;33:1053–4.
Ellington S, Strid P, Tong VT, et al. Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status - United States, January 22- June 7, 2020. MMWR Morb Mortal Wkly Rep 2020;69:769–75.
Golemi Minga I, Golemi L, Tafur A, Pursnani A. The novel coronavirus disease (COVID-19) and its impact on cardiovascular disease. Cardiol Rev 2020;28:163–76
Guo T, Fan Y, Chen M, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol 2020;5:811–8.
Juusela A, Nazir M, Gimovsky M. Two cases of coronavirus 2019-related cardiomyopathy in pregnancy. Am J Obstet Gynecol MFM 2020;2:100113.
Lippi G, Lavie CJ, Sanchis-Gomar F. Cardiac troponin I in patients with coronavirus disease 2019 (COVID-19): evidence from a metaanalysis. Prog Cardiovasc Dis 2020;63:390–1.
Mercedes BR, Serwat A, Naffaa L, et al. New-onset myocardial injury in pregnant patients with coronavirus disease 2019: a case series of 15 patients. Am J Obstet Gynecol 2021;224:387.e1-9.
Pierce-Williams RAM, Burd J, Felder L, et al. Clinical course of severe and critical coronavirus disease 2019 in hospitalized pregnancies: a United States cohort study. Am J Obstet Gynecol MFM 2020;2:100134.
Sandoval Y, Jaffe AS. Key points about myocardial injury and cardiac troponin in COVID- 19. 2020. Available at: https://www.acc.org/latest-in-cardiology/articles/2020/07/17/08/00/ key-points-about-myocardial-injury-and-cardiactroponin-in-covid-19. Accessed Nov. 16, 2020.
Shi S, Qin M, Shen B, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol 2020;5:802–10.
Szekely Y, Lichter Y, Taieb P, et al. Spectrum of cardiac manifestations in COVID-19: a systematic echocardiographic study. Circulation 2020;142:342–53.
