Cardiac Troponin-I and COVID-19: A Prognostic Tool for In-Hospital Mortality
Baher Al Abbasi1, Pedro Torres1, Fergie Ramos-Tuarez2
1Department of Internal Medicine, University of Miami/JFK Medical Center Palm Beach Regional GME Consortium, Atlantis, FL, USA.
Cardiology Research
|November 23, 2020
Summary
Elevated cardiac troponin-I levels in COVID-19 patients indicate a higher risk of in-hospital death. A normal troponin-I level within 24 hours predicts a better survival outcome for coronavirus disease 2019 patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Coronavirus disease 2019 (COVID-19) has caused over 800,000 global fatalities.
- There is an urgent need for prognostic tools to predict survival and hospitalization in COVID-19 patients.
Purpose of the Study:
- To investigate the utility of cardiac troponin-I levels for early prognostication in COVID-19 patients.
- To determine if troponin-I levels can predict in-hospital mortality.
Main Methods:
- Retrospective cohort study of 257 COVID-19 patients admitted between March 2020 and July 2020.
- Patients were stratified into elevated vs. normal cardiac troponin-I groups within 24 hours of admission.
- Analysis focused on demographic, clinical characteristics, and in-hospital mortality.
Main Results:
- Patients with elevated troponin-I were older and had more comorbidities (hypertension, diabetes, atrial fibrillation, coronary artery disease, heart failure).
- Elevated troponin-I was associated with significantly higher in-hospital mortality (52% vs. 10%, P < 0.0001).
- Troponin-I had a negative predictive value of 89.7% and a positive predictive value of 51.9% for mortality.
Conclusions:
- Troponin-I elevation is common in COVID-19 and linked to fatal outcomes.
- A normal troponin-I level in the first 24 hours has a high negative predictive value for mortality.
- Normal troponin-I levels predict favorable survival in hospitalized COVID-19 patients.
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