Dr Januzzi : COVID-19 may manifest from a cardiac perspective in a number of different ways – atrial fibrillation is common, heart muscle dysfunction whether related to myocarditis (which is probably a little bit more uncommon, but may still happen or not) and stress cardiomyopathy. There is also triggering of ischaemic heart disease and other mechanisms lead to a reasonably high percentage of patients with severe COVID-19 showing signs of myocardial injury with an elevated troponin but also elevated NT-proBNP.
COVID-19 patients who are not critically ill may present with NT-proBNP, but these are not helpful for predicting who will get sick. Monitoring it during hospitalisation is helpful, as the patients that are becoming increasingly symptomatic will have a rise in their values over time. It is seen that more frequently patients come in with a primary cardiac diagnosis like acute heart failure and COVID-19. The reassuring fact remains that NT-proBNP stays just as diagnostic in those patients. So an important point is NT-proBNP, can still be used to diagnose heart failure in COVID-19.
