Article ; Online: Using high sensitivity cardiac troponin values in patients with SARS-CoV-2 infection (COVID-19): The Padova experience.
2021 Volume 90, Page(s) 8–14
Abstract: ... injury using high-sensitivity cardiac troponin I (hs-cTnI) and to understand how to use its prognostic ... predictor of mortality in COVID-19 patients. A value < 5 ng/L identified patients at low risk. ... abilities.: Methods: Retrospective study of patients with COVID-19 presenting to an Emergency Department ...
| Abstract | Background: The spectrum of Coronavirus Disease 2019 (COVID-19) is broad and thus early appropriate risk stratification can be helpful. Our objectives were to define the frequency of myocardial injury using high-sensitivity cardiac troponin I (hs-cTnI) and to understand how to use its prognostic abilities. Methods: Retrospective study of patients with COVID-19 presenting to an Emergency Department (ED) in Italy in 2020. Hs-cTnI was sampled based on clinical judgment. Myocardial injury was defined as values above the sex-specific 99th percentile upper reference limits (URLs). Most data is from the initial hospital value. Results: 426 unique patients were included. Hs-cTnI was measured in 313 (73.5%) patients; 85 (27.2%) had myocardial injury at baseline. Patients with myocardial injury had higher mortality during hospitalization (hazard ratio = 9 [95% confidence interval (CI) 4.55-17.79], p < 0.0001). Multivariable analysis including clinical and laboratory variables demonstrated an AUC of 0.942 with modest additional value of hs-cTnI. Myocardial injury was associated with mortality in patients with low APACHE II scores (<13) [OR (95% CI): 4.15 (1.40, 14.22), p = 0.014] but not in those with scores > 13 [OR (95% CI): 0.48 (0.08, 2.65), p = 0.40]. Initial hs-cTnI < 5 ng/L identified 33% of patients that were at low risk with 97.8% sensitivity (95% CI 88.7, 99.6) and 99.2% negative predictive value. Type 1 myocardial infarction (MI) and type 2 MI were infrequent. Conclusions: hs-cTnI at baseline is a significant predictor of mortality in COVID-19 patients. A value < 5 ng/L identified patients at low risk. |
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| MeSH term(s) | Aged ; Aged, 80 and over ; Biomarkers/blood ; COVID-19/epidemiology ; COVID-19/mortality ; Cardiomyopathies/epidemiology ; Cardiomyopathies/mortality ; Emergency Service, Hospital ; Female ; Hospitalization ; Humans ; Italy/epidemiology ; Male ; Middle Aged ; Myocardial Infarction/epidemiology ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Risk Assessment ; Risk Factors ; SARS-CoV-2 ; Troponin I/blood | |||||
| Chemical Substances | Biomarkers ; Troponin I | |||||
| Language | English | |||||
| Publishing date | 2021-01-30 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 390372-2 | |||||
| ISSN | 1873-2933 ; 0009-9120 | |||||
| ISSN (online) | 1873-2933 | |||||
| ISSN | 0009-9120 | |||||
| DOI | 10.1016/j.clinbiochem.2021.01.006 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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