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. 2020 Dec;11(6):398-404.
doi: 10.14740/cr1159. Epub 2020 Oct 23.

Cardiac Troponin-I and COVID-19: A Prognostic Tool for In-Hospital Mortality

Baher Al Abbasi  1 , Pedro Torres  1 , Fergie Ramos-Tuarez  2 , Nakeya Dewaswala  1 , Ahmed Abdallah  1 , Kai Chen  1 , Mohamed Abdul Qader  1 , Riya Job  1 , Samar Aboulenain  1 , Karolina Dziadkowiec  1 , Huzefa Bhopalwala  3 , Jesus E Pino  2 , Robert D Chait  2
Affiliations

Cardiac Troponin-I and COVID-19: A Prognostic Tool for In-Hospital Mortality

Baher Al Abbasi et al. Cardiol Res. 2020 Dec.

Abstract

Background: The number of fatalities due to coronavirus disease 2019 (COVID-19) is escalating with more than 800,000 deaths globally. The scientific community remains in urgent need of prognostic tools to determine the probability of survival in patients with COVID-19 and to determine the need for hospitalization.

Methods: This is a retrospective cohort study of patients with a diagnosis of COVID-19 admitted to a tertiary center between March 2020 and July 2020. Patients age 18 years and older were stratified into two groups based on their troponin-I level in the first 24 h of admission (groups: elevated vs. normal). The aim of the study is to explore the utility of cardiac troponin-I level for early prognostication of patients with COVID-19.

Results: This cohort of 257 patients included 122/257 (47%) women with a mean age of 63 ± 17 years. Patients with an elevated troponin-I level were more likely to be older (77 ± 13 vs. 58 ± 16 years, P < 0.0001), have a history of hypertension (P < 0.0001), diabetes mellitus (P = 0.0019), atrial fibrillation or flutter (P = 0.0009), coronary artery disease (P < 0.0001), and chronic heart failure (P = 0.0011). Patients with an elevated troponin-I level in the first 24 h of admission were more likely to have higher in-hospital mortality (52% vs. 10%, P < 0.0001). Troponin-I level in the first 24 h of admission had a negative predictive value of 89.7% and a positive predictive value of 51.9% for all-cause in-hospital mortality.

Conclusions: Troponin-I elevation is commonly seen in patients with COVID-19 and is significantly associated with fatal outcomes. However, a normal troponin-I level in the first 24 h of admission had a high negative predictive value for all-cause in-hospital mortality, thereby predicting favorable survival at the time of discharge.

Keywords: COVID-19; Cardiovascular medicine; Mortality; Myocardial injury; SARS-CoV-2; Troponin-I.

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Conflict of interest statement

There are no relationships with any industry. All authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

Figure 1
Figure 1
Flowchart for participants’ selection. COVID-19: coronavirus disease 2019.
See this image and copyright information in PMC

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