High sensitivity troponin and COVID-19 outcomes

Abstract

Background Recent reports have demonstrated high troponin levels in patients affected with COVID-19. In the present study, we aimed to determine the association between admission and peak troponin levels and COVID-19 outcomes. Methods This was an observational multi-ethnic multi-centre study in a UK cohort of 434 patients admitted and diagnosed COVID-19 positive, across six hospitals in London, UK during the second half of March 2020. Results Myocardial injury, defined as positive troponin during admission was observed in 288 (66.4%) patients. Age (OR: 1.68 [1.49–1.88], p < .001), hypertension (OR: 1.81 [1.10–2.99], p = .020) and moderate chronic kidney disease (OR: 9.12 [95% CI: 4.24–19.64], p < .001) independently predicted myocardial injury. After adjustment, patients with positive peak troponin were more likely to need non-invasive and mechanical ventilation (OR: 2.40 [95% CI: 1.27–4.56], p = .007, and OR: 6.81 [95% CI: 3.40–13.62], p < .001, respectively) and urgent renal replacement therapy (OR: 4.14 [95% CI: 1.34–12.78], p = .013). With regards to events, and after adjustment, positive peak troponin levels were independently associated with acute kidney injury (OR: 6.76 [95% CI: 3.40–13.47], p < .001), venous thromboembolism (OR: 11.99 [95% CI: 3.20–44.88], p < .001), development of atrial fibrillation (OR: 10.66 [95% CI: 1.33–85.32], p = .026) and death during admission (OR: 2.40 [95% CI: 1.34–4.29], p = .003). Similar associations were observed for admission troponin. In addition, median length of stay in days was shorter for patients with negative troponin levels: 8 (5–13) negative, 14 (7–23) low-positive levels and 16 (10–23) high-positive ( p < .001). Conclusions Admission and peak troponin appear to be predictors for cardiovascular and non-cardiovascular events and outcomes in COVID-19 patients, and their utilisation may have an impact on patient management.

Lymphocyte count is a universal predictor to the health status and outcomes of patients with coronavirus disease 2019 (COVID-19): A systematic review and meta-regression analysis

“…will be augmented to reflecting the impairment situation. 30,117,118 Our study confirmed again that levels of several laboratory data although not all are profound predictors to disease severity or mortality for COVID-19 patients as compared with previous studies. 15,28,29,30,114 It is no surprise that lymphocyte count played such an important role to COVID-19 patients in defending SARS-CoV-2.…”

The Pathogenesis and Long-Term Consequences of COVID-19 Cardiac Injury

“… 8 Subsequent studies have reported an association between biochemical evidence of myocardial injury and increased risk for arrhythmic events, extracardiac complications (acute respiratory distress syndrome, mechanical ventilation), and mortality in hospitalized patients. 9 , 10 However, the majority of patients with COVID-19 with elevated cardiac enzymes have no underlying epicardial coronary artery occlusion (effectively excluding type 1 myocardial infarction [MI]) or clinical symptoms of a cardiac pathology. 11 This prompted some to propose that COVID-19 predisposes to a nonspecific myocardial injury biomarker leak not indicative of a type 2 MI.…”

Troponin Is Independently Associated With Death in Patients With Covid: A Retrospective Study

“…Subsequent studies from western countries show a broad prevalence of myocardial injury. In general, there appears to be higher frequency of troponin elevation in hospitalized patients in European and USA populations, when compared to China, with an incidence rising above 50% in some instances (11,(14)(15)(16)(17)(18)(19)(20)(21). A large meta-analysis including 49 studies from a combination of the USA, Europe and China showed an incidence of troponin elevation in 20.8%…”