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. 2020 Aug;10(4):678-686.
doi: 10.21037/cdt-20-510.

Analysis of influencing factors related to elevated serum troponin I level for COVID-19 patients in Yichang, China

Zhi-Xing Fan  1   2   3   4 , Jun Yang  1   2   3 , Jing Zhang  1   2   3 , Chao He  1   2   3 , Hui Wu  1   2   3 , Chao-Jun Yang  1   2   3 , Tao Zheng  1   2   3 , Cong Ma  1   2   3 , Zu-Jin Xiang  1   2   3 , Yu-Hong Zhai  1   2   3 , Jing Jiang  5 , Shao-Qin Qiu  6 , Jian Yang  7
Affiliations

Analysis of influencing factors related to elevated serum troponin I level for COVID-19 patients in Yichang, China

Zhi-Xing Fan et al. Cardiovasc Diagn Ther. 2020 Aug.

Abstract

Background: Cardiac injury is a common condition among hospitalized coronavirus disease 2019 (COVID-19) patients, and is associated with a higher risk of mortality. However, the mechanism of myocardial injury in COVID-19 remains unclear. In this retrospective study, we compared the clinical characteristics of COVID-19 patients with different troponin I (TnI) levels during hospitalization to provide a clinical reference for the identification of those at high-risk.

Methods: In total, 218 patients diagnosed with COVID-19 in Yichang Central People's Hospital and Yichang Third People's Hospital between January 23 and February 19, 2020 were initially included. Of these patients, 89 underwent TnI testing during hospitalization and were finally included in the study. The medical history, clinical signs and symptoms at the time of admission, and laboratory test results were recorded. The patients were assigned to the normal TnI group (TnI <0.01 µg/L; n=67) or the elevated TnI group (TnI >0.01 µg/L; n=22).

Results: The incidence of elevated TnI in our patient cohort was 24.7%. There were significant differences between the two groups in the following factors: history of coronary heart disease (CHD), age, lymphocyte count, prothrombin time (PT), activated partial thromboplastin time (APTT), and levels of interleukin (IL)-6, C-reactive protein (CRP), myoglobin (MYO), lactate dehydrogenase (LDH), and albumin (all P<0.05). Binary logistic analysis showed that a history of CHD, age, lymphocyte count, IL-6, APTT, and MYO were influencing factors of elevated serum TnI.

Conclusions: A history of CHD, advanced age, decreased lymphocyte count, increased IL-6, increased MYO, and prolonged APTT were independent influencing factors of elevated TnI in COVID-19 patients. COVID-19 patients with these characteristics are prone to myocardial injury.

Keywords: Coronavirus disease 2019 patients (COVID-19 patients); influencing factors; myocardial injury; troponin I (TnI).

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/cdt-20-510). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The predictive nomogram for TnI elevation. TnI, troponin I; CHD, coronary heart disease; APTT, activated partial thromboplastin time; IL-6, interleukin 6.
See this image and copyright information in PMC

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