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Cardiac troponin and COVID‐19 severity: Results from BIOCOVID study

2021; Wiley; Volume: 51; Issue: 6 Linguagem: Inglês

10.1111/eci.13532

1365-2362

Luis García de Guadiana‐Romualdo, Daniel Morell‐García, Olaia Rodríguez‐Fraga, Cristian Morales‐Indiano, Ana María Lourdes Padilla Jiménez, José Ignacio Gutiérrez Revilla, Eloísa Urrechaga, J.M. Álamo-Martínez, Ana María Hernando Holgado, María-Carmen Lorenzo-Lozano, Silvia Sánchez Fdez‐Pacheco, Patricia de la Hera Cagigal, María Ángeles Juncos Tobarra, Juan A. Vílchez, Isabel Vírseda Chamorro, Irene Gutiérrez García, Yolanda Pastor Murcia, L. Frías, Laura Altimira Queral, Elisa Nuez‐Zaragoza, Juan Adell Ruiz de León, Alicia Ruiz Ripa, Paloma Salas Gómez‐Pablos, Iria Cebreiros López, Amaia Fernandez-Uriarte, Álex Larruzea, María Luisa López Yepes, Natalia Sancho‐Rodríguez, María C. Zamorano Andrés, José Pedregosa Díaz, Cristina Acevedo Alcaraz, A.L. Blázquez Manzanera, Sonia Pérez Sanmartín, María del Carmen Baamonde Calzada, Marina Vera, Elena Valera Nuñez, Magdalena Canalda Campás, Sara García Muñoz, Josep Miquel Bauçà, Luis Vicente Gutiérrez, Laura Jiménez Añón, Alfonso Pérez Martínez, Aurelio Pons Castillo, Ruth González Tamayo, J. Vivancos, Maria José Alcaide Martín, Vicente Ferrer Díaz de Brito Fernández, Vicente Aguadero, María Gloria García Arévalo, María Arnaldos Carrillo, Mercedes González Morales, María Núñez Gárate, Cristina Ruiz Iruela, Patricia Esteban Torrella, Martí Vila Pérez, José M. Egea-Caparrós, Luis Felipe Loaiza Sáenz, Amparo Galán Ortega, Luciano Consuegra‐Sánchez,

COVID-19 and healthcare impacts

Abstract Background Myocardial injury is a common finding in COVID‐19 strongly associated with severity. We analysed the prevalence and prognostic utility of myocardial injury, characterized by elevated cardiac troponin, in a large population of COVID‐19 patients, and further evaluated separately the role of troponin T and I. Methods This is a multicentre, retrospective observational study enrolling patients with laboratory‐confirmed COVID‐19 who were hospitalized in 32 Spanish hospitals. Elevated troponin levels were defined as values above the sex‐specific 99th percentile upper reference limit, as recommended by international guidelines. Thirty‐day mortality was defined as endpoint. Results A total of 1280 COVID‐19 patients were included in this study, of whom 187 (14.6%) died during the hospitalization. Using a nonspecific sex cut‐off, elevated troponin levels were found in 344 patients (26.9%), increasing to 384 (30.0%) when a sex‐specific cut‐off was used. This prevalence was significantly higher (42.9% vs 21.9%; P < .001) in patients in whom troponin T was measured in comparison with troponin I. Sex‐specific elevated troponin levels were significantly associated with 30‐day mortality, with adjusted odds ratios (ORs) of 3.00 for total population, 3.20 for cardiac troponin T and 3.69 for cardiac troponin I. Conclusion In this multicentre study, myocardial injury was a common finding in COVID‐19 patients. Its prevalence increased when a sex‐specific cut‐off and cardiac troponin T were used. Elevated troponin was an independent predictor of 30‐day mortality, irrespective of cardiac troponin assay and cut‐offs to detect myocardial injury. Hence, the early measurement of cardiac troponin may be useful for risk stratification in COVID‐19.