tetano
Editor, Senior Moderator
Cardiol Res
. 2020 Dec;11(6):398-404.
doi: 10.14740/cr1159. Epub 2020 Oct 23.
Cardiac Troponin-I and COVID-19: A Prognostic Tool for In-Hospital Mortality
Baher Al Abbasi[SUP] 1 [/SUP], Pedro Torres[SUP] 1 [/SUP], Fergie Ramos-Tuarez[SUP] 2 [/SUP], Nakeya Dewaswala[SUP] 1 [/SUP], Ahmed Abdallah[SUP] 1 [/SUP], Kai Chen[SUP] 1 [/SUP], Mohamed Abdul Qader[SUP] 1 [/SUP], Riya Job[SUP] 1 [/SUP], Samar Aboulenain[SUP] 1 [/SUP], Karolina Dziadkowiec[SUP] 1 [/SUP], Huzefa Bhopalwala[SUP] 3 [/SUP], Jesus E Pino[SUP] 2 [/SUP], Robert D Chait[SUP] 2 [/SUP]
Affiliations
Abstract
Background: The number of fatalities due to coronavirus disease 2019 (COVID-19) is escalating with more than 800,000 deaths globally. The scientific community remains in urgent need of prognostic tools to determine the probability of survival in patients with COVID-19 and to determine the need for hospitalization.
Methods: This is a retrospective cohort study of patients with a diagnosis of COVID-19 admitted to a tertiary center between March 2020 and July 2020. Patients age 18 years and older were stratified into two groups based on their troponin-I level in the first 24 h of admission (groups: elevated vs. normal). The aim of the study is to explore the utility of cardiac troponin-I level for early prognostication of patients with COVID-19.
Results: This cohort of 257 patients included 122/257 (47%) women with a mean age of 63 ? 17 years. Patients with an elevated troponin-I level were more likely to be older (77 ? 13 vs. 58 ? 16 years, P < 0.0001), have a history of hypertension (P < 0.0001), diabetes mellitus (P = 0.0019), atrial fibrillation or flutter (P = 0.0009), coronary artery disease (P < 0.0001), and chronic heart failure (P = 0.0011). Patients with an elevated troponin-I level in the first 24 h of admission were more likely to have higher in-hospital mortality (52% vs. 10%, P < 0.0001). Troponin-I level in the first 24 h of admission had a negative predictive value of 89.7% and a positive predictive value of 51.9% for all-cause in-hospital mortality.
Conclusions: Troponin-I elevation is commonly seen in patients with COVID-19 and is significantly associated with fatal outcomes. However, a normal troponin-I level in the first 24 h of admission had a high negative predictive value for all-cause in-hospital mortality, thereby predicting favorable survival at the time of discharge.
Keywords: COVID-19; Cardiovascular medicine; Mortality; Myocardial injury; SARS-CoV-2; Troponin-I.
. 2020 Dec;11(6):398-404.
doi: 10.14740/cr1159. Epub 2020 Oct 23.
Cardiac Troponin-I and COVID-19: A Prognostic Tool for In-Hospital Mortality
Baher Al Abbasi[SUP] 1 [/SUP], Pedro Torres[SUP] 1 [/SUP], Fergie Ramos-Tuarez[SUP] 2 [/SUP], Nakeya Dewaswala[SUP] 1 [/SUP], Ahmed Abdallah[SUP] 1 [/SUP], Kai Chen[SUP] 1 [/SUP], Mohamed Abdul Qader[SUP] 1 [/SUP], Riya Job[SUP] 1 [/SUP], Samar Aboulenain[SUP] 1 [/SUP], Karolina Dziadkowiec[SUP] 1 [/SUP], Huzefa Bhopalwala[SUP] 3 [/SUP], Jesus E Pino[SUP] 2 [/SUP], Robert D Chait[SUP] 2 [/SUP]
Affiliations
- PMID: 33224386
- PMCID: PMC7666590
- DOI: 10.14740/cr1159
Abstract
Background: The number of fatalities due to coronavirus disease 2019 (COVID-19) is escalating with more than 800,000 deaths globally. The scientific community remains in urgent need of prognostic tools to determine the probability of survival in patients with COVID-19 and to determine the need for hospitalization.
Methods: This is a retrospective cohort study of patients with a diagnosis of COVID-19 admitted to a tertiary center between March 2020 and July 2020. Patients age 18 years and older were stratified into two groups based on their troponin-I level in the first 24 h of admission (groups: elevated vs. normal). The aim of the study is to explore the utility of cardiac troponin-I level for early prognostication of patients with COVID-19.
Results: This cohort of 257 patients included 122/257 (47%) women with a mean age of 63 ? 17 years. Patients with an elevated troponin-I level were more likely to be older (77 ? 13 vs. 58 ? 16 years, P < 0.0001), have a history of hypertension (P < 0.0001), diabetes mellitus (P = 0.0019), atrial fibrillation or flutter (P = 0.0009), coronary artery disease (P < 0.0001), and chronic heart failure (P = 0.0011). Patients with an elevated troponin-I level in the first 24 h of admission were more likely to have higher in-hospital mortality (52% vs. 10%, P < 0.0001). Troponin-I level in the first 24 h of admission had a negative predictive value of 89.7% and a positive predictive value of 51.9% for all-cause in-hospital mortality.
Conclusions: Troponin-I elevation is commonly seen in patients with COVID-19 and is significantly associated with fatal outcomes. However, a normal troponin-I level in the first 24 h of admission had a high negative predictive value for all-cause in-hospital mortality, thereby predicting favorable survival at the time of discharge.
Keywords: COVID-19; Cardiovascular medicine; Mortality; Myocardial injury; SARS-CoV-2; Troponin-I.