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Prognostic performance of troponin in COVID-19: A diagnostic meta-analysis and meta-regression

Arief Wibowo1, Raymond Pranata2, Mohammad Rizki Akbar1

  • 1Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Bandung, Indonesia.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|March 5, 2021
PubMed

Insights

Elevated troponin levels in COVID-19 patients indicate a higher risk of mortality. This biomarker is a significant predictor of death, even when considering other health conditions.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Biomarkers

Background:

  • Cardiac injury is common in COVID-19 patients, increasing mortality risk.
  • Elevated troponin levels suggest myocardial damage and predict mortality.
  • Understanding troponin's prognostic value in COVID-19 is crucial.

Purpose of the Study:

  • To assess the prognostic value of elevated troponin for mortality in COVID-19 patients.
  • To identify factors influencing the relationship between troponin and mortality.
  • To analyze troponin's predictive accuracy using meta-analysis.

Main Methods:

  • Systematic literature review and meta-analysis of PubMed, Scopus, and Embase databases.
  • Inclusion of 13 studies with 12,262 patients.
  • Definition of elevated troponin as above the 99th percentile upper reference limit (URL).

Main Results:

  • Elevated troponin was observed in 31% of patients and associated with a 4.75-fold increased mortality risk.
  • The association between troponin and mortality was not affected by age, gender, hypertension, diabetes, or coronary artery disease.
  • Elevated troponin demonstrated 55% sensitivity and 80% specificity for predicting mortality.

Conclusions:

  • Elevated troponin is a significant predictor of mortality in COVID-19 patients.
  • The prognostic value of troponin is consistent across various demographic and clinical factors.
  • Troponin testing can aid in risk stratification for COVID-19 patients.
Abstract

Keywords:
COVID-19Cardiac injuryHeartPrognosisTroponin

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