Introduction
Coronavirus disease 2019 (COVID-19), is caused by an enveloped, non-segmented, single-stranded, positive-sense RNA virus belonging to the Coronaviridae family (SARS-CoV-2)[1] , emerged in China’s region Wuhan[2] , spreading worldwide and becoming one of the most lethal pandemic with a rapid increase of affected people. The SARS-CoV-2 infection clinical progression is mostly characterized by acute lung injury. Yet, some COVID-19 patients showed also neurological signs, acute myocardial injury, heart failure, myocarditis and hypercoagulability, such as pulmonary embolism[3]. Cardiac biomarkers can play an essential role in the diagnosis, management, and prognosis of COVID 19. In fact, during hospitalization, these patients develop biochemical abnormalities, with increasing of all Troponins (TnT), B-type natriuretic peptide (NT-pro-BNP) and creatine kinase-myocardial band (CK-MB) levels. This situation helps us to predict adverse outcomes, especially in patients with cardiovascular comorbidities or risk factors. Despite initially COVID-19 was identified above all as a respiratory disease with severe interstitial pneumonia and risk of acute respiratory distress syndrome, data emerged demonstrated a myocardial involvement which determines a high risk of adverse events and increasing of mortality. According to Danwang et al[4], COVID-19 patients are divided into mild, moderate, severe, and critical classifications basing on biochemical parameters.
The aim of our review is to evaluate data on the predisposition to worse outcomes, comparing the severity of COVID-19 and levels of biomarkers.