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Acta Cardiologica Volume 77, 2022 - Issue 1
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Original Scientific Papers

High sensitivity troponin and COVID-19 outcomes

Nikolaos Papageorgioua St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK;b Institute of Cardiovascular Science, University College London, London, UK
,
Catrin Sohrabia St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UKORCID Iconhttps://orcid.org/0000-0003-2773-5659
ORCID Icon,
David Prieto Merinoc Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK;d Applied Statistics in Medical Research Group, Catholic University of Murcia (UCAM), Murcia, SpainORCID Iconhttps://orcid.org/0000-0001-5001-0061
ORCID Icon,
Angelos Tyrlisa St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
,
Abed Elfattah Atieha St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
,
Bunny Saberwala St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
,
Wei-Yao Lima St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
,
Antonio Cretaa St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
,
Mohammed Khanjia St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
,
Reni Rusinovaa St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
,
Bashistraj Chooneeaa St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
,
Raj Khianid Applied Statistics in Medical Research Group, Catholic University of Murcia (UCAM), Murcia, Spain;e Barnett Hospital, London, UK
,
Nadeev Wijesuriyae Barnett Hospital, London, UK;f Royal Free Hospital, London, UK
,
Anna Chowe Barnett Hospital, London, UK;f Royal Free Hospital, London, UK
,
Haroun Butte Barnett Hospital, London, UK;f Royal Free Hospital, London, UK
,
Stefan Brownee Barnett Hospital, London, UK;f Royal Free Hospital, London, UK
,
Nikhil Joshie Barnett Hospital, London, UK;f Royal Free Hospital, London, UK
,
Jamie Kaye Barnett Hospital, London, UK;f Royal Free Hospital, London, UK
,
Syed Ahsana St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
&
Rui Providenciaa St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK;g Institute of Health Informatics Research, University College of London, London, UKCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0001-9141-9883
ORCID Icon show all
Pages 81-88 | Received 02 Dec 2020, Accepted 03 Feb 2021, Published online: 08 Mar 2021
 
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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.

Disclosure statement

The authors report no conflicts of interest.

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