High troponin levels in patients hospitalized for coronavirus disease 2019: a maker or a marker of prognosis?
J Cardiovasc Med (Hagerstown)
; 22(11): 828-831, 2021 11 01.
Article
in English
| MEDLINE | ID: covidwho-1406806
ABSTRACT
AIMS:
Controversial data have been published regarding the prognostic role of cardiac troponins in patients who need hospitalization because of coronavirus disease 2019 (COVID-19). The aim of the study was to assess the role of high-sensitivity troponin plasma levels and of respiratory function at admission on all-cause deaths in unselected patients hospitalized because of COVID-19.METHODS:
We pooled individual patient data from observational studies that assessed all-cause mortality of unselected patients hospitalized for COVID-19. The individual data of 722 patients were included. The ratio of partial pressure arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) and high-sensitivity troponins was reported at admission in all patients. This meta-analysis was registered on PROSPERO (CRD42020213209).RESULTS:
After a median follow-up of 14âdays, 180 deaths were observed. At multivariable regression analysis, age [hazard ratio (HR) 1.083, 95% confidence interval (CI) 1.061-1.105, Pâ<â0.0001], male sex (HR 2.049, 95% CI 1.319-3.184, Pâ=â0.0014), moderate-severe renal dysfunction (estimated glomerular filtration rate â<â30âmL/min/m2) (HR 2.108, 95% CI 1.237-3.594, Pâ=â0.0061) and lower PaO2/FiO2 (HR 0.901, 95% CI 0.829-0.978, Pâ=â0.0133) were the independent predictors of death. A linear increase in the HR was associated with decreasing values of PaO2/FiO2 below the normality threshold. On the contrary, the HR curve for troponin plasma levels was near-flat with large CI for values above the normality thresholds.CONCLUSION:
In unselected patients hospitalized for COVID-19, mortality is mainly driven by male gender, older age and respiratory failure. Elevated plasma levels of high-sensitivity troponins are not an independent predictor of worse survival when respiratory function is accounted for.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Oxygen
/
Respiratory Function Tests
/
Troponin
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Observational study
/
Prognostic study
/
Reviews
Limits:
Humans
Language:
English
Journal:
J Cardiovasc Med (Hagerstown)
Journal subject:
Vascular Diseases
/
Cardiology
Year:
2021
Document Type:
Article
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