Abstract
Background: High sensitivity cardiac troponin-T (hs-TnT) has been associated with mortality in patients hospitalized with COVID-19. We aimed to determine if hs-TnT levels and their timing are independent predictors of adverse events in these patients.
Design: Retrospective chart review was performed for all patients hospitalized at our institution between 23 March 2020 and 13 April 2020 who were found to be COVID-19-positive. Clinical, demographic, and laboratory variables including initial and peak hs-TnT were recorded. Univariable and multivariable analyses were completed for a primary composite endpoint of in-hospital death, intubation, need for critical care, or cardiac arrest.
Results: In the 276 patients analysed, initial hs-TnT above the median (≥17 ng/L) was associated with increased length of stay, need for vasoactive medications, and death, along with the composite endpoint (OR 3.92, p < 0.001). Multivariable analysis demonstrated that elevated initial hs-TnT was independently associated with the primary endpoint (OR 2.92, p = 0.01). Late-peaking hs-TnT (OR 2.19 for each additional day until peak, p < 0.001) was also independently associated with the composite endpoint.
Conclusions: In patients hospitalized with COVID-19, hs-TnT identifies patients at high risk for adverse in-hospital events, and trends of hs-TnT over time, particularly during the first day, provide additional prognostic information.
Keywords: COVID-19; Troponin; biomarker; cardiac outcomes; risk stratification.
【저자키워드】 COVID-19, Biomarker, troponin, cardiac outcomes, risk stratification, 【초록키워드】 Biomarker, Critical care, Mortality, intubation, troponin, medications, Cardiac arrest, Laboratory, cardiac troponin, adverse events, risk stratification, sensitivity, clinical, adverse event, Patient, death, prognostic, information, patients, Troponin-T, primary endpoint, Analysis, independent predictors, high risk, composite endpoint, In-hospital death, In-hospital, multivariable analysis, multivariable analyses, primary composite endpoint, Univariable and multivariable analyses, variable, Vasoactive, initial, identify, elevated, events, was performed, analysed, determine, demonstrated, were recorded, independent predictor, patients hospitalized, the median, the primary endpoint, with COVID-19, 【제목키워드】 sensitivity, adverse event, patients with COVID-19,