Key result
In patients hospitalized with COVID-19, elevated troponin was associated with increased mortality (HR 3.22), and ECG abnormalities further reduced survival in those with mildly elevated troponin.
Why the study?
Troponin elevation is frequent in hospitalized COVID-19 patients, and its correlation across different ranges alongside ECG abnormalities with mortality needed assessment.
Cohort (n=204)
No
Answers are grounded in this paper and cite their sources.
May support troponin and ECG for prognostication in COVID-19; hypothesis-generating, needs prospective validation.
Background the COVID19 pandemic has resulted in worldwide morbidity at unprecedented scale. Troponin elevation is a frequent laboratory finding in hospitalized patients with the disease, and may reflect direct vascular injury or nonspecific supply-demand imbalance. In this work, we assessed the correlation between different ranges of Troponin elevation, Electrocardiographic (ECG) abnormalities and mortality. Methods We retrospectively studied 204 consecutive patients hospitalized at NYU Langone Health with COVID19. Serial ECG tracings were evaluated in conjunction with laboratory data including Troponin. Mortality was analyzed in respect to the degree of Troponin elevation and the presence of ECG changes including ST elevation, ST depression or T wave inversion. Results Mortality increased in parallel with increase in Troponin elevation groups and reached 60% when Troponin was >1 ng/ml. In patients with mild Troponin rise (0.05 – 1.00 ng/ml) the presence of ECG abnormality resulted in significantly greater mortality. Conclusion ECG repolarization abnormalities may represent a marker of clinical severity in patients with mild elevation in Troponin values. This finding can be used to enhance risk stratification in patients hospitalized with COVID19.
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Chorin et al. (2020) conducted a cohort in COVID-19 (n=204). Elevated troponin (>0.05 ng/mL) vs. Negative troponin (≤0.05 ng/mL) was evaluated on Mortality (HR 3.22, 95% CI 1.71-6.05, p=<0.01). In patients hospitalized with COVID-19, elevated troponin was associated with increased mortality (HR 3.22), and ECG abnormalities further reduced survival in those with mildly elevated troponin.
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