Article ; Online: Sex differences in the prognostic value of troponin and D-dimer in COVID-19 illness.
Heart & lung : the journal of critical care
2022 Volume 58, Page(s) 1–5
Abstract: Background: Male sex, elevated troponin levels, and elevated D-dimer levels are associated ... 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 ...
| 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. |
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| MeSH term(s) | Humans ; Female ; Male ; COVID-19 ; Prognosis ; Troponin ; Retrospective Studies ; Sex Characteristics |
| Chemical Substances | Troponin ; fibrin fragment D |
| Language | English |
| Publishing date | 2022-10-26 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 193129-5 |
| ISSN | 1527-3288 ; 0147-9563 |
| ISSN (online) | 1527-3288 |
| ISSN | 0147-9563 |
| DOI | 10.1016/j.hrtlng.2022.10.012 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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