Sex differences in the prognostic value of troponin and D-dimer in COVID-19 illness.
Heart Lung
; 58: 1-5, 2022 Oct 26.
Article
in English
| MEDLINE | ID: covidwho-2243548
ABSTRACT
BACKGROUND:
Male sex, elevated troponin levels, and elevated D-dimer levels are associated with more complicated COVID-19 illness and greater mortality; however, while there are known sex differences in the prognostic value of troponin and D-dimer in other disease states, it is unknown whether they exist in the setting of COVID-19.OBJECTIVE:
We assessed whether sex modified the relationship between troponin, D-dimer, and severe COVID-19 illness (defined as mechanical ventilation, ICU admission or transfer, discharge to hospice, or death).METHODS:
We conducted a retrospective cohort study of patients hospitalized with COVID-19 at a large, academic health system. We used multivariable regression to assess associations between sex, troponin, D-dimer, and severe COVID-19 illness, adjusting for demographic, clinical, and laboratory covariates. To test whether sex modified the relationship between severe COVID-19 illness and troponin or D-dimer, models with interaction terms were utilized.RESULTS:
Among 4,574 patients hospitalized with COVID-19, male sex was associated with higher levels of troponin and greater odds of severe COVID-19 illness, but lower levels of initial D-dimer when compared with female sex. While sex did not modify the relationship between troponin level and severe COVID-19 illness, peak D-dimer level was more strongly associated with severe COVID-19 illness in male patients compared to female patients (males OR=2.91, 95%CI=2.63-2.34, p<0.001; females OR=2.31, 95%CI=2.04-2.63, p<0.001; p-interaction=0.005).CONCLUSION:
Sex did not modify the association between troponin level and severe COVID-19 illness, but did modify the association between peak D-dimer and severe COVID-19 illness, suggesting greater prognostic value for D-dimer in males with COVID-19.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Language:
English
Journal:
Heart Lung
Year:
2022
Document Type:
Article
Affiliation country:
J.hrtlng.2022.10.012
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