tetano
Editor, Senior Moderator
J Clin Med
. 2021 Apr 13;10(8):1656.
doi: 10.3390/jcm10081656.
Admission High-Sensitive Cardiac Troponin T Level Increase Is Independently Associated with Higher Mortality in Critically Ill Patients with COVID-19: A Multicenter Study
Romaric Larcher[SUP] 1 2 [/SUP], Noemie Besnard[SUP] 3 [/SUP], Aziz Akouz[SUP] 4 [/SUP], Emmanuelle Rabier[SUP] 5 [/SUP], Lauranne Teule[SUP] 4 [/SUP], Thomas Vandercamere[SUP] 5 [/SUP], Samuel Zozor[SUP] 1 [/SUP], Matthieu Amalric[SUP] 3 [/SUP], Racim Benomar[SUP] 3 [/SUP], Vincent Brunot[SUP] 3 [/SUP], Philippe Corne[SUP] 3 [/SUP], Olivier Barbot[SUP] 4 [/SUP], Anne-Marie Dupuy[SUP] 1 [/SUP], Jean-Paul Cristol[SUP] 1 2 [/SUP], Kada Klouche[SUP] 2 3 [/SUP]
Affiliations
Abstract
Background: In coronavirus disease 2019 (COVID-19) patients, increases in high-sensitive cardiac troponin T (hs-cTnT) have been reported to be associated with worse outcomes. In the critically ill, the prognostic value of hs-cTnT, however, remains to be assessed given that most previous studies have involved a case mix of non- and severely ill COVID-19 patients.
Methods: We conducted, from March to May 2020, in three French intensive care units (ICUs), a multicenter retrospective cohort study to assess in-hospital mortality predictability of hs-cTnT levels in COVID-19 patients.
Results: 111 laboratory-confirmed COVID-19 patients (68% of male, median age 67 (58-75) years old) were included. At ICU admission, the median Charlson Index, Simplified Acute Physiology Score II, and PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] were at 3 (2-5), 37 (27-48), and 140 (98-154), respectively, and the median hs-cTnT serum levels were at 16.0 (10.1-31.9) ng/L. Seventy-five patients (68%) were mechanically ventilated, 41 (37%) were treated with norepinephrine, and 17 (15%) underwent renal replacement therapy. In-hospital mortality was 29% (32/111) and was independently associated with lower PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] and higher hs-cTnT serum levels.
Conclusions: At ICU admission, besides PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB], hs-cTnT levels may allow early risk stratification and triage in critically ill COVID-19 patients.
Keywords: COVID-19; ICU; SARS-CoV-2; high-sensitive cardiac troponin T; myocardial injury; outcomes.
. 2021 Apr 13;10(8):1656.
doi: 10.3390/jcm10081656.
Admission High-Sensitive Cardiac Troponin T Level Increase Is Independently Associated with Higher Mortality in Critically Ill Patients with COVID-19: A Multicenter Study
Romaric Larcher[SUP] 1 2 [/SUP], Noemie Besnard[SUP] 3 [/SUP], Aziz Akouz[SUP] 4 [/SUP], Emmanuelle Rabier[SUP] 5 [/SUP], Lauranne Teule[SUP] 4 [/SUP], Thomas Vandercamere[SUP] 5 [/SUP], Samuel Zozor[SUP] 1 [/SUP], Matthieu Amalric[SUP] 3 [/SUP], Racim Benomar[SUP] 3 [/SUP], Vincent Brunot[SUP] 3 [/SUP], Philippe Corne[SUP] 3 [/SUP], Olivier Barbot[SUP] 4 [/SUP], Anne-Marie Dupuy[SUP] 1 [/SUP], Jean-Paul Cristol[SUP] 1 2 [/SUP], Kada Klouche[SUP] 2 3 [/SUP]
Affiliations
- PMID: 33924475
- DOI: 10.3390/jcm10081656
Abstract
Background: In coronavirus disease 2019 (COVID-19) patients, increases in high-sensitive cardiac troponin T (hs-cTnT) have been reported to be associated with worse outcomes. In the critically ill, the prognostic value of hs-cTnT, however, remains to be assessed given that most previous studies have involved a case mix of non- and severely ill COVID-19 patients.
Methods: We conducted, from March to May 2020, in three French intensive care units (ICUs), a multicenter retrospective cohort study to assess in-hospital mortality predictability of hs-cTnT levels in COVID-19 patients.
Results: 111 laboratory-confirmed COVID-19 patients (68% of male, median age 67 (58-75) years old) were included. At ICU admission, the median Charlson Index, Simplified Acute Physiology Score II, and PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] were at 3 (2-5), 37 (27-48), and 140 (98-154), respectively, and the median hs-cTnT serum levels were at 16.0 (10.1-31.9) ng/L. Seventy-five patients (68%) were mechanically ventilated, 41 (37%) were treated with norepinephrine, and 17 (15%) underwent renal replacement therapy. In-hospital mortality was 29% (32/111) and was independently associated with lower PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] and higher hs-cTnT serum levels.
Conclusions: At ICU admission, besides PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB], hs-cTnT levels may allow early risk stratification and triage in critically ill COVID-19 patients.
Keywords: COVID-19; ICU; SARS-CoV-2; high-sensitive cardiac troponin T; myocardial injury; outcomes.