Troponin and short-term mortality in hospitalised patients with COVID-19 infection: a retrospective study in an inner-city London hospital

Abstract

ObjectiveTo investigate the association between troponin positivity in patients hospitalised with COVID-19 and increased mortality in the short term.SettingHomerton University Hospital, an inner-city district general hospital in East London.DesignA single-centre retrospective observational study.ParticipantsAll adults admitted with swab-proven RT-PCR COVID-19 to Homerton University Hospital from 4 February 2020 to 30 April 2020 (n=402).Outcome measuresWe analysed demographic and biochemical data collected from the patient record according to the primary outcome of death at 28 days during hospital admission.MethodsTroponin positivity was defined above the upper limit of normal according to our local laboratory assay (>15.5 ng/L for females, >34 ng/L for males). Univariate and multivariate logistical regression analyses were performed to evaluate the link between troponin positivity and death.ResultsMean age was 65.3 years for men compared with 63.8 years for women. A χ2 test showed survival of patients with COVID-19 was significantly higher in those with a negative troponin (p=3.23×10−10) compared with those with a positive troponin. In the multivariate logistical regression, lung disease, age, troponin positivity and continuous positive airway pressure were all significantly associated with death, with an area under the curve of 0.889, sensitivity of 0.886 and specificity of 0.629 for the model. Within this model, troponin positivity was independently associated with short-term mortality (OR 2.97, 95% CI 1.34 to 6.61, p=0.008).ConclusionsWe demonstrated an independent association between troponin positivity and increased short-term mortality in COVID-19 in a London district general hospital.

Normal high-sensitivity cardiac troponin for ruling-out inpatient mortality in acute COVID-19

“…In this study, patients with elevated vs normal troponin levels had similar rates of non-fatal complications, despite exhibiting significant differences in mortality rates. This observation appears similar to some other studies [20,41]. The cause of mortality in COVID-19 patients is often multi-factorial and remains incompletely understood [39].…”

COVID-19 Tanılı Hastalarda Serum Prokalsitonin Düzeyi ile Mortalite ve Hastalık Şiddeti Arasında Bir İlişki Var mı?

“…A study by Shyam-Sundar et al [9] showed a relationship between troponin and mortality in COVID-19 cases. In another study of 2716 COVID-19 cases conducted by Case et al, [10] in-hospital mortality was found to be higher in patients with elevated troponin levels (12.2%; p<0.001).…”

Increasing cardiac troponin-I level as a cardiac injury index correlates with in-hospital mortality and biofactors in severe hospitalised COVID-19 patients

“…Noteworthy, patients with cardiac injury were older, had more comorbidities such as hypertension, diabetes, coronary heart disease, and chronic heart failure, higher levels of CRP, TPI, N-terminal pro-B-type natriuretic peptide, and Cr, and had higher mortality than those without cardiac injury (51.2% vs 4.5%) [ 22 , 23 ]. Sundar et al also supported that patients with elevated levels were older, had more comorbidities such as ischaemic heart disease, heart failure, chronic kidney disease, higher white cell count, and consequently had higher in-hospital mortality (53.2% vs 19.0%) and death following readmission (3.2% vs 0.0%) than non-elevated patients [ 24 ]. Lyu and coworkers showed that patients with cardiac injury had higher age, history of heart failure, blood urea nitrogen (BUN) and Cr levels, and higher in-hospital mortality than the no cardiac injury group [ 25 ].…”

“…In addition, Ayad and coworkers reported that the levels of TPI, D-dimer, CRP, and WBCs were remarkably higher in COVID-19 patients who died during hospitalisation than survivors [ 26 ]. Similarly, lung disease, age, TPI positivity, and continuous positive airway pressure ventilation were meaningfully associated with in-hospital mortality in COVID-19 patients [ 24 ].…”