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Observational Study
. 2022 Feb;77(1):81-88.
doi: 10.1080/00015385.2021.1887586. Epub 2021 Mar 8.

High sensitivity troponin and COVID-19 outcomes

Nikolaos Papageorgiou  1   2 , Catrin Sohrabi  1 , David Prieto Merino  3   4 , Angelos Tyrlis  1 , Abed Elfattah Atieh  1 , Bunny Saberwal  1 , Wei-Yao Lim  1 , Antonio Creta  1 , Mohammed Khanji  1 , Reni Rusinova  1 , Bashistraj Chooneea  1 , Raj Khiani  4   5 , Nadeev Wijesuriya  5   6 , Anna Chow  5   6 , Haroun Butt  5   6 , Stefan Browne  5   6 , Nikhil Joshi  5   6 , Jamie Kay  5   6 , Syed Ahsan  1 , Rui Providencia  1   7
Affiliations
Observational Study

High sensitivity troponin and COVID-19 outcomes

Nikolaos Papageorgiou et al. Acta Cardiol. 2022 Feb.

Abstract

Background: Recent reports have demonstrated high troponin levels in patients affected with COVID-19. In the present study, we aimed to determine the association between admission and peak troponin levels and COVID-19 outcomes.

Methods: This was an observational multi-ethnic multi-centre study in a UK cohort of 434 patients admitted and diagnosed COVID-19 positive, across six hospitals in London, UK during the second half of March 2020.

Results: Myocardial injury, defined as positive troponin during admission was observed in 288 (66.4%) patients. Age (OR: 1.68 [1.49-1.88], p < .001), hypertension (OR: 1.81 [1.10-2.99], p = .020) and moderate chronic kidney disease (OR: 9.12 [95% CI: 4.24-19.64], p < .001) independently predicted myocardial injury. After adjustment, patients with positive peak troponin were more likely to need non-invasive and mechanical ventilation (OR: 2.40 [95% CI: 1.27-4.56], p = .007, and OR: 6.81 [95% CI: 3.40-13.62], p < .001, respectively) and urgent renal replacement therapy (OR: 4.14 [95% CI: 1.34-12.78], p = .013). With regards to events, and after adjustment, positive peak troponin levels were independently associated with acute kidney injury (OR: 6.76 [95% CI: 3.40-13.47], p < .001), venous thromboembolism (OR: 11.99 [95% CI: 3.20-44.88], p < .001), development of atrial fibrillation (OR: 10.66 [95% CI: 1.33-85.32], p = .026) and death during admission (OR: 2.40 [95% CI: 1.34-4.29], p = .003). Similar associations were observed for admission troponin. In addition, median length of stay in days was shorter for patients with negative troponin levels: 8 (5-13) negative, 14 (7-23) low-positive levels and 16 (10-23) high-positive (p < .001).

Conclusions: Admission and peak troponin appear to be predictors for cardiovascular and non-cardiovascular events and outcomes in COVID-19 patients, and their utilisation may have an impact on patient management.

Keywords: COVID-19; Troponin; cardiovascular disease; outcomes.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1.
Figure 1.
Flowchart illustrating cohort selection.
Figure 2.
Figure 2.
Association (adjusted OR) of the different troponin-derived variables with procedures and clinical events.
See this image and copyright information in PMC

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