Cardiac troponin and COVID-19 severity: Results from BIOCOVID study.

BACKGROUND: Myocardial injury is a common finding in COVID-19 strongly associated with severity. We analysed the prevalence and prognostic utility of myocardial injury, characterized by elevated cardiac troponin, in a large population of COVID-19 patients, and further evaluated separately the role o...

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Autores: de Guadiana-Romualdo, LG, Morell-Garcia, D, Rodriguez-Fraga, O, Morales-Indiano, C, Jimenez, AMLP, Revilla, JIG, Urrechaga, E, Alamo, JM, Holgado, AMH, Lorenzo-Lozano, MD, Fdez-Pacheco, SS, Cagigal, PD, Tobarra, MAJ, Vilchez, JA, Chamorro, IV, Garcia, IG, Murcia, YP, Frias, LS, Queral, LA, Nuez-Zaragoza, E, de Leon, JAR, Ripa, AR, Gomez-Pablos, PS, Lopez, IC, Uriarte, AF, Larruzea, A, Yepes, MLL, Sancho-Rodriguez, N, Andres, MCZ, Diaz, JP, Alcaraz, CA, Manzanera, ALB, Sanmartin, SP, Calzada, MDB, Vera, M, Nunez, EV, Campas, MC, Munoz, SG, Bauca, JM, Gutierrez, LV, Anon, LJ, Martinez, AP, Castillo, AP, Tamayo, RG, Vivancos, JF, Martin, MJA, Fernandez, VFDD, Aguadero, V, Arevalo, MGG, Carrillo, MA, Morales, MG, Garate, MN, Iruela, CR, Torrella, PE, Perez, MV, Egea-Caparros, JM, Saenz, L, Ortega, AG, Consuegra-Sanchez, L
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p10903
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/10903
Access Level:acceso abierto
Palabra clave:COVID-19
SARS-CoV-2
cardiac troponin I
cardiac troponin T
myocardial injury
prognosis
Descripción
Sumario:BACKGROUND: Myocardial injury is a common finding in COVID-19 strongly associated with severity. We analysed the prevalence and prognostic utility of myocardial injury, characterized by elevated cardiac troponin, in a large population of COVID-19 patients, and further evaluated separately the role of troponin T and I. METHODS: This is a multicentre, retrospective observational study enrolling patients with laboratory-confirmed COVID-19 who were hospitalized in 32 Spanish hospitals. Elevated troponin levels were defined as values above the sex-specific 99th percentile upper reference limit, as recommended by international guidelines. Thirty-day mortality was defined as endpoint. RESULTS: A total of 1280 COVID-19 patients were included in this study, of whom 187 (14.6%) died during the hospitalization. Using a nonspecific sex cut-off, elevated troponin levels were found in 344 patients (26.9%), increasing to 384 (30.0%) when a sex-specific cut-off was used. This prevalence was significantly higher (42.9% vs 21.9%; P < .001) in patients in whom troponin T was measured in comparison with troponin I. Sex-specific elevated troponin levels were significantly associated with 30-day mortality, with adjusted odds ratios (ORs) of 3.00 for total population, 3.20 for cardiac troponin T and 3.69 for cardiac troponin I. CONCLUSION: In this multicentre study, myocardial injury was a common finding in COVID-19 patients. Its prevalence increased when a sex-specific cut-off and cardiac troponin T were used. Elevated troponin was an independent predictor of 30-day mortality, irrespective of cardiac troponin assay and cut-offs to detect myocardial injury. Hence, the early measurement of cardiac troponin may be useful for risk stratification in COVID-19.

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