Praveen Gupta, Anunay Gupta, Sandeep Bansal, Ira Balakrishnan
{"title":"新冠肺炎住院患者的心脏肌钙蛋白：发病率、预测因素和结果。","authors":"Praveen Gupta, Anunay Gupta, Sandeep Bansal, Ira Balakrishnan","doi":"10.1177/00045632231216599","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The incidence, predictors, and association of cardiac troponin with mortality in hospitalized COVID-19 were not adequately studied in the past and were also not reported from an Indian hospital.</p><p><strong>Methods: </strong>In this retrospective cohort study, the cardiac troponin of 240 hospitalized COVID-19 patients was measured. The incidence, predictors, and association of elevated cardiac troponin with in-hospital mortality were determined among hospitalized COVID-19 patients.</p><p><strong>Results: </strong>The cardiac troponin was elevated in 12.9% (31/240) of the patients. The troponin was elevated in the patients in the older age group (64 years vs. 55 years, <i>p</i> = .002), severe COVID-19 illness (SpO2 < 90%) (93.5% vs. 60.8%, <i>p</i> < .001), low arterial oxygen saturation (SpO2) (80% vs. 88%, <i>p</i> = .001), and low PaO2/FiO2 ratio (<i>p</i> < .0001). The patients with elevated cardiac troponin had elevated total leukocyte counts (TLC) (<i>p</i> = .001), liver enzyme (<i>p</i> = .025), serum creatinine (<i>p</i> = .011), N-terminal-Pro Brain natriuretic peptide (<i>p</i> < .0001), and d-dimer (<i>p</i> < .0001). The majority of the patients with elevated cardiac troponin were admitted to the intensive care unit (90.3% vs. 51.2%; <i>p</i> < .0001), were on a ventilator (61.3% vs. 21.5%; <i>p</i> < .0001), and had higher mortality (64.5% vs. 19.6%; <i>p</i> < .0001). The Kaplan-Meir survival analysis showed that the patients with elevated troponin had worse survival (<i>p</i> log-rank<.0001). Age, NT-ProBNP, d-dimer, and ventilator were the predictors of elevated troponin in multivariate logistic regression analysis. The Cox-regression analysis showed a significant association between elevated cardiac troponin and in-hospital mortality (adjusted hazard ratio 2.13; 95% confidence interval [CI] 1.145-3.97; <i>p</i> = .017). Two-thirds (65%) of patients with elevated cardiac troponin died during their hospital stay.</p><p><strong>Conclusions: </strong>COVID-19 patients with elevated cardiac troponin had severe COVID illness, were more commonly admitted to an intensive care unit, were on a ventilator, and had high in-hospital mortality.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"255-264"},"PeriodicalIF":2.1000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cardiac troponin in hospitalized COVID-19 patients: Incidence, predictors, and outcomes.\",\"authors\":\"Praveen Gupta, Anunay Gupta, Sandeep Bansal, Ira Balakrishnan\",\"doi\":\"10.1177/00045632231216599\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The incidence, predictors, and association of cardiac troponin with mortality in hospitalized COVID-19 were not adequately studied in the past and were also not reported from an Indian hospital.</p><p><strong>Methods: </strong>In this retrospective cohort study, the cardiac troponin of 240 hospitalized COVID-19 patients was measured. The incidence, predictors, and association of elevated cardiac troponin with in-hospital mortality were determined among hospitalized COVID-19 patients.</p><p><strong>Results: </strong>The cardiac troponin was elevated in 12.9% (31/240) of the patients. The troponin was elevated in the patients in the older age group (64 years vs. 55 years, <i>p</i> = .002), severe COVID-19 illness (SpO2 < 90%) (93.5% vs. 60.8%, <i>p</i> < .001), low arterial oxygen saturation (SpO2) (80% vs. 88%, <i>p</i> = .001), and low PaO2/FiO2 ratio (<i>p</i> < .0001). The patients with elevated cardiac troponin had elevated total leukocyte counts (TLC) (<i>p</i> = .001), liver enzyme (<i>p</i> = .025), serum creatinine (<i>p</i> = .011), N-terminal-Pro Brain natriuretic peptide (<i>p</i> < .0001), and d-dimer (<i>p</i> < .0001). The majority of the patients with elevated cardiac troponin were admitted to the intensive care unit (90.3% vs. 51.2%; <i>p</i> < .0001), were on a ventilator (61.3% vs. 21.5%; <i>p</i> < .0001), and had higher mortality (64.5% vs. 19.6%; <i>p</i> < .0001). The Kaplan-Meir survival analysis showed that the patients with elevated troponin had worse survival (<i>p</i> log-rank<.0001). Age, NT-ProBNP, d-dimer, and ventilator were the predictors of elevated troponin in multivariate logistic regression analysis. The Cox-regression analysis showed a significant association between elevated cardiac troponin and in-hospital mortality (adjusted hazard ratio 2.13; 95% confidence interval [CI] 1.145-3.97; <i>p</i> = .017). Two-thirds (65%) of patients with elevated cardiac troponin died during their hospital stay.</p><p><strong>Conclusions: </strong>COVID-19 patients with elevated cardiac troponin had severe COVID illness, were more commonly admitted to an intensive care unit, were on a ventilator, and had high in-hospital mortality.</p>\",\"PeriodicalId\":8005,\"journal\":{\"name\":\"Annals of Clinical Biochemistry\",\"volume\":\" \",\"pages\":\"255-264\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Clinical Biochemistry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/00045632231216599\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/11/20 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICAL LABORATORY TECHNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Clinical Biochemistry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00045632231216599","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/11/20 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}
Cardiac troponin in hospitalized COVID-19 patients: Incidence, predictors, and outcomes.
Background: The incidence, predictors, and association of cardiac troponin with mortality in hospitalized COVID-19 were not adequately studied in the past and were also not reported from an Indian hospital.
Methods: In this retrospective cohort study, the cardiac troponin of 240 hospitalized COVID-19 patients was measured. The incidence, predictors, and association of elevated cardiac troponin with in-hospital mortality were determined among hospitalized COVID-19 patients.
Results: The cardiac troponin was elevated in 12.9% (31/240) of the patients. The troponin was elevated in the patients in the older age group (64 years vs. 55 years, p = .002), severe COVID-19 illness (SpO2 < 90%) (93.5% vs. 60.8%, p < .001), low arterial oxygen saturation (SpO2) (80% vs. 88%, p = .001), and low PaO2/FiO2 ratio (p < .0001). The patients with elevated cardiac troponin had elevated total leukocyte counts (TLC) (p = .001), liver enzyme (p = .025), serum creatinine (p = .011), N-terminal-Pro Brain natriuretic peptide (p < .0001), and d-dimer (p < .0001). The majority of the patients with elevated cardiac troponin were admitted to the intensive care unit (90.3% vs. 51.2%; p < .0001), were on a ventilator (61.3% vs. 21.5%; p < .0001), and had higher mortality (64.5% vs. 19.6%; p < .0001). The Kaplan-Meir survival analysis showed that the patients with elevated troponin had worse survival (p log-rank<.0001). Age, NT-ProBNP, d-dimer, and ventilator were the predictors of elevated troponin in multivariate logistic regression analysis. The Cox-regression analysis showed a significant association between elevated cardiac troponin and in-hospital mortality (adjusted hazard ratio 2.13; 95% confidence interval [CI] 1.145-3.97; p = .017). Two-thirds (65%) of patients with elevated cardiac troponin died during their hospital stay.
Conclusions: COVID-19 patients with elevated cardiac troponin had severe COVID illness, were more commonly admitted to an intensive care unit, were on a ventilator, and had high in-hospital mortality.
期刊介绍：
Annals of Clinical Biochemistry is the fully peer reviewed international journal of the Association for Clinical Biochemistry and Laboratory Medicine.
Annals of Clinical Biochemistry accepts papers that contribute to knowledge in all fields of laboratory medicine, especially those pertaining to the understanding, diagnosis and treatment of human disease. It publishes papers on clinical biochemistry, clinical audit, metabolic medicine, immunology, genetics, biotechnology, haematology, microbiology, computing and management where they have both biochemical and clinical relevance. Papers describing evaluation or implementation of commercial reagent kits or the performance of new analysers require substantial original information. Unless of exceptional interest and novelty, studies dealing with the redox status in various diseases are not generally considered within the journal''s scope. Studies documenting the association of single nucleotide polymorphisms (SNPs) with particular phenotypes will not normally be considered, given the greater strength of genome wide association studies (GWAS). Research undertaken in non-human animals will not be considered for publication in the Annals.
Annals of Clinical Biochemistry is also the official journal of NVKC (de Nederlandse Vereniging voor Klinische Chemie) and JSCC (Japan Society of Clinical Chemistry).
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