tetano
Editor, Senior Moderator
J Clin Med
. 2020 Dec 17;9(12):E4078.
doi: 10.3390/jcm9124078.
Prognostic Value of Troponin Elevation in COVID-19 Hospitalized Patients
Elena-Mihaela Cordeanu[SUP] 1 [/SUP], Nicolas Duthil[SUP] 1 [/SUP], Francois Severac[SUP] 2 [/SUP], H?l?ne Lambach[SUP] 1 [/SUP], Jonathan Tousch[SUP] 1 [/SUP], Lucas Jambert[SUP] 3 [/SUP], Corina Mirea[SUP] 1 [/SUP], Alexandre Delatte[SUP] 4 [/SUP], Wa?l Younes[SUP] 5 [/SUP], Anne-Sophie Frantz[SUP] 1 [/SUP], Hamid Merdji[SUP] 6 [/SUP], Val?rie Schini-Kerth[SUP] 7 [/SUP], Pascal Bilbault[SUP] 8 [/SUP], Patrick Ohlmann[SUP] 9 [/SUP], Emmanuel Andres[SUP] 10 [/SUP], Dominique Stephan[SUP] 1 [/SUP]
Affiliations
Abstract
(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) penetrates the respiratory epithelium through angiotensin-converting enzyme-2 (ACE2) binding. Myocardial and endothelial expression of ACE2 could account for the growing body of reported evidence of myocardial injury in severe forms of Human Coronavirus Disease 2019 (COVID-19). We aimed to provide insight into the impact of troponin (hsTnI) elevation on SARS-CoV-2 outcomes in patients hospitalized for COVID-19. (2) Methods: This was a retrospective analysis of hospitalized adult patients with the SARS-CoV-2 infection admitted to a university hospital in France. The observation period ended at hospital discharge. (3) Results: During the study period, 772 adult, symptomatic COVID-19 patients were hospitalized for more than 24 h in our institution, of whom 375 had a hsTnI measurement and were included in this analysis. The median age was 66 (55-74) years, and there were 67% of men. Overall, 205 (55%) patients were placed under mechanical ventilation and 90 (24%) died. A rise in hsTnI was noted in 34% of the cohort, whereas only three patients had acute coronary syndrome (ACS) and one case of myocarditis. Death occurred more frequently in patients with hsTnI elevation (HR 3.95, 95% CI 2.69-5.71). In the multivariate regression model, a rise in hsTnI was independently associated with mortality (OR 3.12, 95% CI 1.49-6.65) as well as age ≥ 65 years old (OR 3.17, 95% CI 1.45-7.18) and CRP ≥ 100 mg/L (OR 3.62, 95% CI 1.12-13.98). After performing a sensitivity analysis for the missing values of hsTnI, troponin elevation remained independently and significantly associated with death (OR 3.84, 95% CI 1.78-8.28). (4) Conclusion: Our study showed a four-fold increased risk of death in the case of a rise in hsTnI, underlining the prognostic value of troponin assessment in the COVID-19 context.
Keywords: COVID-19; SARS-CoV-2; biomarker; cardiovascular; myocardial injury; troponin.
. 2020 Dec 17;9(12):E4078.
doi: 10.3390/jcm9124078.
Prognostic Value of Troponin Elevation in COVID-19 Hospitalized Patients
Elena-Mihaela Cordeanu[SUP] 1 [/SUP], Nicolas Duthil[SUP] 1 [/SUP], Francois Severac[SUP] 2 [/SUP], H?l?ne Lambach[SUP] 1 [/SUP], Jonathan Tousch[SUP] 1 [/SUP], Lucas Jambert[SUP] 3 [/SUP], Corina Mirea[SUP] 1 [/SUP], Alexandre Delatte[SUP] 4 [/SUP], Wa?l Younes[SUP] 5 [/SUP], Anne-Sophie Frantz[SUP] 1 [/SUP], Hamid Merdji[SUP] 6 [/SUP], Val?rie Schini-Kerth[SUP] 7 [/SUP], Pascal Bilbault[SUP] 8 [/SUP], Patrick Ohlmann[SUP] 9 [/SUP], Emmanuel Andres[SUP] 10 [/SUP], Dominique Stephan[SUP] 1 [/SUP]
Affiliations
- PMID: 33348719
- DOI: 10.3390/jcm9124078
Abstract
(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) penetrates the respiratory epithelium through angiotensin-converting enzyme-2 (ACE2) binding. Myocardial and endothelial expression of ACE2 could account for the growing body of reported evidence of myocardial injury in severe forms of Human Coronavirus Disease 2019 (COVID-19). We aimed to provide insight into the impact of troponin (hsTnI) elevation on SARS-CoV-2 outcomes in patients hospitalized for COVID-19. (2) Methods: This was a retrospective analysis of hospitalized adult patients with the SARS-CoV-2 infection admitted to a university hospital in France. The observation period ended at hospital discharge. (3) Results: During the study period, 772 adult, symptomatic COVID-19 patients were hospitalized for more than 24 h in our institution, of whom 375 had a hsTnI measurement and were included in this analysis. The median age was 66 (55-74) years, and there were 67% of men. Overall, 205 (55%) patients were placed under mechanical ventilation and 90 (24%) died. A rise in hsTnI was noted in 34% of the cohort, whereas only three patients had acute coronary syndrome (ACS) and one case of myocarditis. Death occurred more frequently in patients with hsTnI elevation (HR 3.95, 95% CI 2.69-5.71). In the multivariate regression model, a rise in hsTnI was independently associated with mortality (OR 3.12, 95% CI 1.49-6.65) as well as age ≥ 65 years old (OR 3.17, 95% CI 1.45-7.18) and CRP ≥ 100 mg/L (OR 3.62, 95% CI 1.12-13.98). After performing a sensitivity analysis for the missing values of hsTnI, troponin elevation remained independently and significantly associated with death (OR 3.84, 95% CI 1.78-8.28). (4) Conclusion: Our study showed a four-fold increased risk of death in the case of a rise in hsTnI, underlining the prognostic value of troponin assessment in the COVID-19 context.
Keywords: COVID-19; SARS-CoV-2; biomarker; cardiovascular; myocardial injury; troponin.