Cardiac Troponin-I and COVID-19: A Prognostic Tool for In-Hospital Mortality

Abbasi, Baher Al; Torres, Pedro Iturralde; Ramos-Tuarez, Fergie; Dewaswala, Nakeya; Abdallah, Ahmed; Chen, Kai; Qader, Mohamed Abdul; Job, Riya; Aboulenain, Samar; Dziadkowiec, Karolina N.; Bhopalwala, Huzefa; Pino, Jesus; Chait, Robert

doi:10.14740/cr1159

Cited by 59 publications

(45 citation statements)

References 28 publications

(30 reference statements)

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“…This project was a single-centered retrospective observational study performed at JFK Medical Center, Atlantis, Florida, USA. We retrospectively analyzed patients diagnosed with COVID-19 between March 2020 and July 2020, who were diagnosed COVID-19 positive by nasopharyngeal swab using the reverse transcription polymerase chain reaction (RT-PCR) [ 7 ]. The patients' electronic health records were analyzed on hospital admission and during the patients’ hospital stay by the study team [ 7 ].…”

Section: Methodsmentioning

confidence: 99%

“…Patients included in the study were age 18 years and older and stratified into two groups based on their MELD score in the first 24 hours of admission (low-score vs. high-score) [ 7 ]. High score is defined as MELD score ≥ 10, while the low score is defined as < 10.…”

Section: Methodsmentioning

confidence: 99%

“…Patients age 18 years and older who were hospitalized with a confirmed positive diagnosis of COVID-19 who had INR, bilirubin, and creatinine collected in the first 24 hours of admission [ 7 ].…”

Section: Methodsmentioning

confidence: 99%

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Model of End-Stage Liver Disease (MELD) Score as a Predictor of In-Hospital Mortality in Patients with COVID-19: A Novel Approach to a Classic Scoring System

Stawinski¹,

Dziadkowiec²,

Al-Abbasi³

et al. 2021

Cureus

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Background Limited data is available for reliable and accurate predictors of in-hospital mortality in patients diagnosed with COVID-19. Methods This scientific study is a retrospective cohort study of patients without a known history of liver diseases who were hospitalized with COVID-19 viral infection. Patients were stratified into low score groups (Model of End-Stage Liver Disease [MELD] score <10) and high score groups (MELD ≥10). Clinical outcomes were evaluated, including in-hospital mortality, hospital length of stay, and intensive care unit length of stay (ICU LOS). Results Our cohort of 186 COVID-19 positive patients included 88 (47%) women with a mean age of 60 years in the low score group and mean age of 73 years in the high score group. Patients in the high score group were older in age (p<0.0001) and more likely to have history of diabetes mellitus (p=0.0020), stage 3 chronic kidney disease (CKD) (p=0.0013), hypertension (p<0.0001), stroke/transient ischemic attack (TIA) (p=0.0163), asthma (p=0.0356), dementia (p<0.0001), and chronic heart failure (p=0.0055). The in-hospital mortality or discharge to hospice rate was significantly higher in the high-score group as opposed to the low-score group (p=0.0014). Conversely, there was no significant difference among both groups in the hospital length of stay (LOS) and ICU LOS (p=0.6929 and p=0.7689, respectively). Conclusion Patients hospitalized with COVID-19 infection and found to have a MELD score greater than or equal to 10 were found to have a higher mortality as compared to their counterparts. Conversely a low MELD score is a very strong indicator of a more favorable prognosis, indicating hospital survival. We propose using the MELD score as an adjunct for risk stratifying patients diagnosed with COVID-19 without prior history of liver dysfunction.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Model of End-Stage Liver Disease (MELD) Score as a Predictor of In-Hospital Mortality in Patients with COVID-19: A Novel Approach to a Classic Scoring System

Stawinski¹,

Dziadkowiec²,

Al-Abbasi³

et al. 2021

Cureus

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“…Seven studies have investigated the prognostic value of elevated cTn in COVID-19. Five utilised cTnI [57][58][59][60][61], one cTnT [62] and one with combined cTnT and cTnI from different institutions [63]. In all cases, an elevated cTn (cTnI, Figure 11a; cTnT Figure 11b) was associated with poor outcome; be it in-hospital mortality, or combined endpoints of all-cause mortality and need for mechanical ventilation.…”

Section: Biomarker Evidence Of Myocardial Injury In Covid-19mentioning

confidence: 99%

Coronavirus Disease: Epidemiology, Aetiology, Pathophysiology and Involvement of the Cardiovascular System

Gaze¹

2021

Cardiac Diseases - Novel Aspects of Cardiac Risk, Cardiorenal Pathology and Cardiac Interventions

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Since the emergence in China of coronavirus disease (COVID-19) in December 2019; the virus causing the pandemic has infected the human population in almost every country and territory on the globe. At the time of writing there are over 84 million confirmed cases of infection and over 1.8 million deaths globally. Rates of infection differ as does the number of severe cases and subsequent deaths between countries and continents. This is due in part to lockdown measures, social distancing and wearing of face coverings. It is also reflected by how healthcare systems record coronavirus deaths along with access to testing as well as tracking and tracing of infected individuals. Symptoms of COVID-19 include a novel persistent cough, fever and anosmia (loss of smell). In most cases, such symptoms are mild. A small proportion of those who become infected however, have a severe reaction to the disease affecting multiple organ systems and often require respiratory support in the intensive care setting. One such physiological system affected is the cardiovascular system. This is likely due to the increased number of ACE2 receptors in co-morbid cardiac pathologies. ACE2 receptors serve as the entry port for the coronavirus into human cells. Those individuals with underlying cardiovascular risk factors are therefore disproportionately at risk of COVID-19 infection. This chapter reviews the aetiology and epidemiology of the coronavirus infection; potential pathophysiological mechanisms of disease involving the cardiovascular system including the clinical utility of biomarkers, electrocardiography and echocardiography as well as autopsy cardiac pathology and histopathology.

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“…Troponin‐I elevation is associated with fatal outcomes, however the etiology of this elevation is unclear. 6 …”

Section: Introductionmentioning

confidence: 99%

Clinical significance of coronavirus disease 2019 in hospitalized patients with myocardial injury

Briscoe

Sykes

Krystofiak

et al. 2021

Clinical Cardiology

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Background The clinical significance of Coronavirus disease 2019 (COVID‐19) as an associate of myocardial injury is controversial. Hypothesis Type 2 MI/Myocardial Injury are associated with worse outcomes if complicated by COVID‐19. Methods This longitudinal cohort study involved consecutive patients admitted to a large urban hospital. Myocardial injury was determined using laboratory records as ≥1 hs‐TnI result >99th percentile (male: >34 ng/L; female: >16 ng/L). Endotypes were defined according to the Fourth Universal Definition of Myocardial Infarction (MI) and COVID‐19 determined using PCR. Outcomes of patients with myocardial injury with and without COVID‐19 were assessed. Results Of 346 hospitalized patients with elevated hs‐TnI, 35 (10.1%) had laboratory‐confirmed COVID‐19 (median age [IQR]; 65 [59–74]; 64.8% male vs. COVID‐19 negative: 74 [63–83] years; 43.7% male). Cardiac endotypes by COVID‐19 status (yes vs. no) were: Type 1 MI (0 [0%] vs. 115 [100%]; p < .0005), Type 2 MI (13 [16.5%] vs. 66 [83.5%]; p = .045), and non‐ischemic myocardial injury (cardiac: 4 [5.8%] vs. 65 [94.2%]; p = .191, non‐cardiac:19 [22.9%] vs. 64 [77.%]; p < .0005). COVID‐19 patients had less comorbidity (median [IQR] Charlson Comorbidity Index: 3.0 [3.0] vs. 5.0 [4.0]; p = .001), similar hs‐TnI concentrations (median [IQR] initial: 46 [113] vs. 62 [138]; p = .199, peak: 122 [474] vs. 79 [220] ng/L; p = .564), longer admission (days) (median [IQR]: 14[19] vs. 6[12]; p = .001) and higher in‐hospital mortality (63.9% vs. 11.3%; OR = 13.2; 95%CI: 5.90, 29.7). Conclusions Cardiac sequelae of COVID‐19 typically manifest as Non‐cardiac myocardial injury/Type 2MI in younger patients with less co‐morbidity. Paradoxically, the admission duration and in‐hospital mortality are increased.

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Cardiac Troponin-I and COVID-19: A Prognostic Tool for In-Hospital Mortality

Cited by 59 publications

References 28 publications

Model of End-Stage Liver Disease (MELD) Score as a Predictor of In-Hospital Mortality in Patients with COVID-19: A Novel Approach to a Classic Scoring System

Model of End-Stage Liver Disease (MELD) Score as a Predictor of In-Hospital Mortality in Patients with COVID-19: A Novel Approach to a Classic Scoring System

Coronavirus Disease: Epidemiology, Aetiology, Pathophysiology and Involvement of the Cardiovascular System

Clinical significance of coronavirus disease 2019 in hospitalized patients with myocardial injury

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