Experience With Cardiology-Oriented Outcomes in Critically Ill Patients With Coronavirus Disease 2019

Connor-Schuler, Randi; Wong, An-Kwok Ian; Fiza, Babar; Lyle, Melissa; Ramonell, Richard P.; Hockstein, Maxwell A.; Chang, George L.; Markham, David W.; Searles, Charles; McDaniel, Michael; Baer, Jefferson; Powell, Cindy; Daniels, Lisa M.

doi:10.1097/cce.0000000000000288

Cited by 1 publication

(1 citation statement)

References 29 publications

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“…In total, this systematic review and meta-analysis included 12,262 patients from 13 studies (Figure 1) (Al Abbasi et al, 2020;Arcari et al, 2020;Connor-Schuler et al, 2020;Du et al, 2020;Heron and Chiu, 2020;Li et al, 2020;Lombardi et al, 2020;Maeda et al, 2020;Raad et al, 2020;Shah et al, 2020;Harmouch et…”

Section: Resultsmentioning

confidence: 99%

Prognostic performance of troponin in COVID-19: A diagnostic meta-analysis and meta-regression

Wibowo

Pranata

Akbar

et al. 2021

International Journal of Infectious Diseases

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Background Cardiac injury is frequently encountered in patients with COVID-19 and is associated with an increased risk of mortality. Elevated troponin may signify myocardial damage and predicts mortality. We aimed to assess the prognostic value of elevated troponin above the 99 th percentile upper reference limit (URL) on mortality and factors affecting their relationship. Methods We performed a comprehensive literature search using PubMed (MEDLINE), Scopus, and Embase from inception of the search databases until 16 th December 2020. The key exposure was elevated serum troponin, defined as troponin (of any type) elevation > 99th percentile URL. The outcome was mortality due to any causes. Results There were a total of 12,262 patients from 13 studies in this systematic review and meta-analysis. Mortality was present in 23% (20-26%) of the patients. Elevated troponin was present in 31% (23-38%) of the patients. Elevated troponin was associated with increased mortality (OR 4.75 [4.07, 5.53], p < 0.001; I 2 : 19.9%). Meta-regression shows that the association did not vary with age (p = 0.218), male gender (p = 0.707), hypertension (p = 0.182), diabetes (p = 0.906), and coronary artery disease (p = 0864). Elevated troponin was associated with sensitivity of 0.55 [0.44, 0.66], specificity of 0.80 [0.71, 0.86], PLR 2.7 of [2.2, 3.3], NLR of 0.56 [0.49, 0.65], DOR of 5 [4, 5], and AUC of 0.73 [0.69, 0.77]. Elevated troponin resulted in a 45% probability for mortality and non-elevated troponin resulted in a 14% probability for mortality. Conclusion Elevated troponin was associated with increased mortality with a 55% sensitivity and 80% specificity.

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