Abstract Background/Introduction There is ample scientific evidence that SARS-CoV-2 infection causes myocardial injury in a significant percentage of patients. This injury is associated with higher overall mortality from all causes. The mechanism by which myocardial injury is caused is not yet clear and may be multifactorial. To our knowledge, there are no studies in the literature that have evaluated specific therapeutic measures focused on myocardial protection. Purpose To determine whether the addition of trimetazidine to usual therapy reduces the extent of myocardial injury compared with usual therapy alone in the acute phase of COVID-19. Methods Eighty patients admitted to a dedicated hospital unit (ward or intensive care unit) with a confirmed diagnosis of moderate to severe acute respiratory syndrome (SARS) due to COVID-19 (laboratory criteria: PCR or positive serology for SARS-CoV-2 or tomographic criteria) were selected. The confirmatory diagnosis was always discussed between a clinician from the unit and an infectious disease specialist. Patients were randomized 1:1 to a control group or an intervention group. The control group received the usual supportive therapy practiced by the unit. The intervention group received the usual supportive therapy practiced by the unit plus trimetazidine during the time of hospitalization in the dedicated unit. The doses of trimetazidine used followed the on label recommendations. The groups were compared regarding myocardial injury assessed by peak release of high-sensitivity troponin. Results The median troponin level found was 22.00 ng/L 7.25; 79.25 in the intervention group and 17.00 ng/L 9.00; 103.00 in the control group (p=0.857). Conclusion Our results did not prove a reduction in myocardial injury in the group using trimetazidine. Our conclusion is that, at least through anti-ischemic action, it is not possible to reduce myocardial injury in hospitalized patients diagnosed with moderate to severe acute respiratory syndrome caused by SARS-CoV-2.
Lima et al. (Sat,) studied this question.