Assessment of the Relationship between Mortality and Troponin I Levels in Hospitalized Patients with the Novel Coronavirus (COVID-19)

Abstract

Background and Objectives: This study aimed to evaluate the relationship between mortality and cardiac laboratory findings in patients who were hospitalized after a positive PCR for COVID-19 infection. Materials and Methods: This study included patients who were admitted to or referred to the hospital between 20 March and 20 June 2020, diagnosed with COVID-19 via a positive RT-PCR from nasal and pharyngeal swab samples. The troponin I level was measured from each patient. Medical records of patients were retrospectively reviewed and analyzed. Results: A hundred and five patients who were diagnosed with COVID-19 and hospitalized, or who died in the hospital due to COVID-19, were included in this study. There was a statistically significant difference between the troponin I high and low level groups in terms of age (years), BMI, shortness of breath (SB), oxygen saturation (%), hypertension, length of stay in the ICU; and for mortality, C-reactive protein, the neutrophil-to-lymphocyte ratio, hemoglobin, lactate dehydrogenase, ferritin, D-dimer, creatine kinase-MB, prothrombin time, calcium, and 25-hydroxy vitamin 25(OH)D3 (all p < 0.05). In the logistic analyses, a significant association was noted between troponin I and the adjusted risk of mortality. A ROC curve analysis identified troponin I values > 7.8 pg/mL as an effective cut-off point in mortality for patients with COVID-19. A troponin I value of higher than 7.8 pg/mL yielded a sensitivity of 78% and a specificity of 86%. Conclusions: The hospital mortality rate was higher among patients diagnosed with COVID-19 accompanied by troponin levels higher than 7.8 pg/mL. Therefore, in patients diagnosed with COVID-19, elevated troponin I levels >7.8 pg/mL can be considered an independent risk factor for mortality.

Association Between Elevated High Sensitivity Cardiac-Troponin I Levels and Increase in Levels of C-Reactive Protein, Interleukin-6, D-Dimer, and Consequent Cardiac Injury and Mortality for Patients With Coronavirus Disease 2019: A Meta-Analysis

“…Search articles shed light that cardiac deterioration happens with COVID-19-associated high Tn concentrations [30]. Tn I was regarded as primary considerable estimator of decease [30]. A valuable search article showed, in-line with the previous literature, Tn concentrations were presented to be highrise in aged sick persons and males [30].…”

“…Tn I was regarded as primary considerable estimator of decease [30]. A valuable search article showed, in-line with the previous literature, Tn concentrations were presented to be highrise in aged sick persons and males [30]. A study conducted by Shi et al…”

“…Initial monitoring of cardiac injury-related biomarkers, involving hs-cTn I, may take part considerably in decreasing hazard of decease in grave circumstance [29]. Search articles shed light that cardiac deterioration happens with COVID-19-associated high Tn concentrations [30]. Tn I was regarded as primary considerable estimator of decease [30].…”

“…High-rise of Tn concentrations in COVID-19 affected individuals is interpreted by a number of potential mechanization [30]. These are: first, viral myocarditis; second, cytokine-induced myocardial damage; third, microangiopathy; and fourth, unmasked coronary artery disease [30]. SARS-CoV-2 spike (S) glycoprotein attaches ACE2 receptors for entrance into target cell [30].…”

Correlation of Low Levels of α-1 Antitrypsin and Elevation of Neutrophil to Lymphocyte Ratio with Higher Mortality in Severe COVID-19 Patients

“…It appears that patients with severe COVID-19 have higher troponin levels [ 36 ]. Some recent data revealed that elevation of troponin is accompanied by higher hospital mortality [ 37 ].…”