Key result
In patients hospitalized with COVID-19 and mild troponin elevation, the presence of T wave inversions on presenting ECG was associated with a significantly increased risk of mortality (HR 2.71).
Why the study?
The correlation between different ranges of Troponin elevation, ECG abnormalities, and mortality in hospitalized COVID-19 patients was unclear.
Cohort (n=204)
No
Answers are grounded in this paper and cite their sources.
T wave inversions may aid risk stratification in COVID-19 with mild troponin elevation; hypothesis-generating and requires prospective validation before changing practice.
Background: The COVID-19 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 non-specific 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 COVID-19. 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 and particularly T wave inversions 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 COVID-19.
No takes yet. Share an insight, caveat, or question.
Chorin et al. (2021) conducted a cohort in COVID-19 (n=204). T wave inversion (in the setting of mild troponin elevation) vs. No T wave inversion was evaluated on Mortality (HR 2.71, 95% CI 1.01-7.25, p=0.04). In patients hospitalized with COVID-19 and mild troponin elevation, the presence of T wave inversions on presenting ECG was associated with a significantly increased risk of mortality (HR 2.71).
Synapse has enriched 10 related papers. Consider them for comparative context: