Details

Autor(en) / Beteiligte

• De Marzo, Vincenzo
• Di Biagio, Antonio
• Della Bona, Roberta
• Vena, Antonio
• Arboscello, Eleonora
• Emirjona, Harusha
• Mora, Sara
• Giacomini, Mauro
• Da Rin, Giorgio
• Pelosi, Paolo
• Bassetti, Matteo
• Ameri, Pietro
• Porto, Italo

Titel

Prevalence and prognostic value of cardiac troponin in elderly patients hospitalized for COVID-19

Ist Teil von

• Journal of geriatric cardiology : JGC, 2021-05, Vol.18 (5), p.338-345

Ort / Verlag

Beijing, China: Science Press

Erscheinungsjahr

2021

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• BACKGROUNDIncreases in cardiac troponin (cTn) in coronavirus disease 2019 (COVID-19) have been associated with worse prognosis. Nonetheless, data about the significance of cTn in elderly subjects with COVID-19 are lacking. METHODSFrom a registry of consecutive patients with COVID-19 admitted to a hub hospital in Italy from 25/02/2020 to 03/07/2020, we selected those ≥ 60 year-old and with cTnI measured within three days from the molecular diagnosis of SARS-CoV-2 infection. When available, a second cTnI value within 48 h was also extracted. The relationship between increased cTnI and all-cause in-hospital mortality was evaluated by a Cox regression model and restricted cubic spline functions with three knots. RESULTSOf 343 included patients (median age: 75.0 (68.0-83.0) years, 34.7% men), 88 (25.7%) had cTnI above the upper-reference limit (0.046 µg/L). Patients with increased cTnI had more comorbidities, greater impaired respiratory exchange and higher inflammatory markers on admission than those with normal cTnI. Furthermore, they died more (73.9%vs. 37.3%, P < 0.001) over 15 (6-25) days of hospitalization. The association of elevated cTnI with mortality was confirmed by the adjusted Cox regression model (HR = 1.61, 95%CI: 1.06-2.52, P = 0.039) and was linear until 0.3 µg/L, with a subsequent plateau. Of 191 (55.7%) patients with a second cTnI measurement, 49 (25.7%) had an increasing trend, which was not associated with mortality (univariate HR = 1.39, 95%CI: 0.87-2.22, P = 0.265). CONCLUSIONSIn elderly COVID-19 patients, an initial increase in cTn is common and predicts a higher risk of death. Serial cTn testing may not confer additional prognostic information.