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Eur. J. Clin. Invest. · Jun 2021
Observational StudyCardiac troponin and COVID-19 severity: results from BIOCOVID study.
- 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, José María Álamo, Ana María Hernando Holgado, María Del Carmen Lorenzo-Lozano, Silvia Sánchez Fdez-Pacheco, Patricia de la Hera Cagigal, María Ángeles Juncos Tobarra, Juan A Vílchez, Isabel Vírseda Chamorro, Irene Gutiérrez Garcia, Yolanda Pastor Murcia, Laura Sahuquillo Frías, Laura Altimira Queral, Elisa Nuez-Zaragoza, Adell Ruiz de LeónJuanJLaboratory Medicine Department, Hospital Universitario Virgen de la Victoria, Málaga, Spain., Alicia Ruiz Ripa, Paloma Salas Gómez-Pablos, Iria Cebreiros López, Amaia Fernández Uriarte, Álex Larruzea, López YepesMaría LuisaMLLaboratory Medicine Department, Hospital Virgen del Castillo, Yecla, Spain., Natalia Sancho-Rodríguez, Zamorano AndrésMaría ConsueloMCLaboratory Medicine Department, Hospital de la Vega Lorenzo Guirao, Cieza, Spain., José Pedregosa Díaz, Cristina Acevedo Alcaraz, Alfonso-L Blázquez Manzanera, Sonia Pérez Sanmartín, Baamonde CalzadaMaría Del CarmenMDCDepartment of Clinical Biochemistry, Hospital Sierrallana, Torrelavega, Spain., Marina Vera, Elena Valera Nuñez, Magdalena Canalda Campás, Sara García Muñoz, Josep Miquel Bauça, Luis Vicente Gutiérrez, Laura Jiménez Añón, Alfonso Pérez Martínez, Aurelio Pons Castillo, Ruth González Tamayo, Jorge Férriz Vivancos, María José Alcaide Martín, Ferrer Díaz de Brito FernándezVicenteVInternal Medicine Department, Sant Boi de Llobregat, Barcelona, Spain., Vicente Aguadero, García ArévaloMaría GloriaMGLaboratory Medicine Department, Hospital Universitario Virgen de la Victoria, Málaga, Spain., María Arnaldos Carrillo, Mercedes González Morales, María Núñez Gárate, Cristina Ruiz Iruela, Esteban TorrellaPatriciaPLaboratory Medicine Department, Hospital General Universitario Reina Sofía, Murcia, Spain., Martí Vila Pérez, Egea-CaparrósJose ManuelJMLaboratory Medicine Department, Hospital Universitario Los Arcos del Mar Menor, San Javier, Spain., Luis Sáenz, Amparo Galán Ortega, and Luciano Consuegra-Sánchez.
- Laboratory Medicine Department, Hospital Universitario Santa Lucía, Cartagena, Spain.
- Eur. J. Clin. Invest. 2021 Jun 1; 51 (6): e13532e13532.
BackgroundMyocardial 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.MethodsThis 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.ResultsA 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.ConclusionIn 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.© 2021 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.
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