Cardiac troponin and COVID-19 severity: Results from BIOCOVID study.
Por:
de Guadiana-Romualdo LG, Morell-García DD, Rodríguez-Fraga O, Morales-Indiano C, María Lourdes Padilla Jiménez A, Gutiérrez Revilla JI, Urrechaga E, Álamo JM, Hernando Holgado AM, Del Carmen Lorenzo Lozano M, Sánchez Fdez-Pacheco S, de la Hera Cagigal P, Juncos Tobarra MÁ, Vílchez JA, Vírseda Chamorro I 1st, Gutiérrez Garcia I, Pastor Murcia Y, Sahuquillo Frías L, Altimira Queral L, Nuez Zaragoza E, de León JAR, Ruiz Ripa A, Salas Gómez-Pablos P, Cebreiros López I, Fernández Uriarte A, Larruzea Á, Luisa López Yepes M, Sancho Rodríguez N, Consuelo Zamorano Andrés M, Pedregosa Díaz J, Acevedo Alcaraz C, Luis Blázquez Manzanera A, Pérez Sanmartín S, Del Carmen Baamonde Calzada M, Vera M, Valera Nuñez E, Canalda Campás M, García Muñoz S, Miquel Bauça Rossello J, Vicente Gutiérrez L, Jiménez Añón L, Pérez Martínez A, Pons Castillo A, González Tamayo R, Férriz Vivancos J, José Alcaide Martín M, Diaz de Brito V, Aguadero V, Gloria García Arévalo M, Arnaldos Carrillo M, González Morales M, Núñez Gárate M, Ruiz Iruela C, Esteban Torrella P, Vila Pérez M, Manuel Egea-Caparrós J, Sáenz L, Galán Ortega A and Consuegra-Sánchez L
Publicada:
1 jun 2021
Ahead of Print:
15 mar 2021
Resumen:
BACKGROUND: Myocardial 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. METHODS: This 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. RESULTS: A 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. CONCLUSION: In 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.
Filiaciones:
de Guadiana-Romualdo LG:
Laboratory Medicine Department, Hospital Universitario Santa Lucía, Cartagena, Spain
Morell-García DD:
Laboratory Medicine Department, Hospital Universitario Son Espases, Palma de Mallorca, Spain
Rodríguez-Fraga O:
Laboratory Medicine Department. Hospital, Universitario La Paz, Madrid, Spain
Morales-Indiano C:
Laboratory Medicine Department. Hospital, Universitari Germans Trias i Pujol, Badalona, Spain
María Lourdes Padilla Jiménez A:
Laboratory Medicine Department. Hospital, Universitario Marqués de Valdecilla, Santander, Spain
Gutiérrez Revilla JI:
Department of Clinical Biochemistry. Hospital Sierrallana, Torrelavega, Spain
Urrechaga E:
Biocruces Bizkaia Health Research Institute, Baracaldo, Vizcaya, Spain
Álamo JM:
Biochemical Laboratory, Hospital Marina Baixa, Villajoyosa Alicante, Spain
Hernando Holgado AM:
Laboratory Medicine Department. Hospital, Universitario Vinalopó, Elche Alicante, Spain
Del Carmen Lorenzo Lozano M:
Laboratory Medicine Department, Complejo Hospitalario de Toledo, Toledo, Spain
Sánchez Fdez-Pacheco S:
Laboratory Medicine Department. Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
de la Hera Cagigal P:
Laboratory Medicine Department. Hospital, Universitario de Basurto, Bilbao, Vizcaya, Spain
Juncos Tobarra MÁ:
Laboratory Medicine Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
Vílchez JA:
Laboratory Medicine Department. Hospital, Universitario Morales Meseguer, Murcia, Spain
Vírseda Chamorro I 1st:
Laboratory Medicine Department, Hospital Arnau de Vilanova, Valencia, Spain
Gutiérrez Garcia I:
Laboratory Medicine Department, Hospital Universitario de Torrevieja, Torrevieja Alicante, Spain
Pastor Murcia Y:
Laboratory Medicine Department, Consorci Hospital General Universitari de València, Valencia, Spain
Sahuquillo Frías L:
Laboratory Medicine Department, Hospital Can Misses, Ibiza, Spain
Altimira Queral L:
Laboratory Medicine Department. Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat Barcelona, Spain
Nuez Zaragoza E:
Laboratory Medicine Department, Consorci Corporació Sanitària Parc Tauli, Sabadell Barcelona, Spain
de León JAR:
Laboratory Medicine Department, Hospital Universitario Virgen de La Victoria, Málaga, Spain
Ruiz Ripa A:
Laboratory Medicine Department, Hospital de Mataró, Mataró Barcelona, Spain
Salas Gómez-Pablos P:
Catlab. Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain
Cebreiros López I:
Laboratory Medicine Department, Hospital Universitario Virgen de La Arrixaca, Murcia, Spain
Fernández Uriarte A:
Catlab. Hospital Universitario Mútua Terrassa, Barcelona, Spain
Larruzea Á:
Laboratory Medicine Department, Fundación Sanitària Hospital de Mollet, Barcelona, Spain
Luisa López Yepes M:
Laboratory Medicine Department, Hospital Virgen del Castillo, Yecla, Spain
Sancho Rodríguez N:
Laboratory Medicine Department, Hospital General Universitario Reina Sofía, Murcia, Spain
Consuelo Zamorano Andrés M:
Laboratory Medicine Department, Hospital de la Vega Lorenzo Guirao, Cieza, Murcia, Spain
Pedregosa Díaz J:
Laboratory Medicine Department, Hospital Verge de la Cinta, Tortosa, Tarragona, Spain
Acevedo Alcaraz C:
Laboratory Medicine Department, Hospital Universitario Los Arcos del Mar Menor, San Javier, Murcia, Spain
Luis Blázquez Manzanera A:
Laboratory Medicine Department, Hospital General Universitario Rafael Méndez, Lorca, Murcia, Spain
Pérez Sanmartín S:
Laboratory Medicine Department. Hospital, Universitario Marqués de Valdecilla, Santander, Spain
Del Carmen Baamonde Calzada M:
Department of Clinical Biochemistry. Hospital Sierrallana, Torrelavega, Spain
Vera M:
Biochemical Laboratory, Hospital Marina Baixa, Villajoyosa Alicante, Spain
Valera Nuñez E:
Laboratory Medicine Department, Complejo Hospitalario de Toledo, Toledo, Spain
Canalda Campás M:
Laboratory Medicine Department. Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
García Muñoz S:
Laboratory Medicine Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
Miquel Bauça Rossello J:
Laboratory Medicine Department, Hospital Universitario Son Espases, Palma de Mallorca, Spain
Vicente Gutiérrez L:
Laboratory Medicine Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
Jiménez Añón L:
Laboratory Medicine Department. Hospital, Universitari Germans Trias i Pujol, Badalona, Spain
Pérez Martínez A:
Laboratory Medicine Department. Hospital, Universitario Morales Meseguer, Murcia, Spain
Pons Castillo A:
Laboratory Medicine Department, Hospital Arnau de Vilanova, Valencia, Spain
González Tamayo R:
Laboratory Medicine Department, Hospital Universitario de Torrevieja, Torrevieja Alicante, Spain
Férriz Vivancos J:
Laboratory Medicine Department, Consorci Hospital General Universitari de València, Valencia, Spain
José Alcaide Martín M:
Laboratory Medicine Department. Hospital, Universitario Marqués de Valdecilla, Santander, Spain
Diaz de Brito V:
Internal Medicine Department, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
Aguadero V:
Laboratory Medicine Department, Consorci Corporació Sanitària Parc Tauli, Sabadell Barcelona, Spain
Gloria García Arévalo M:
Laboratory Medicine Department, Hospital Universitario Virgen de La Victoria, Málaga, Spain
Arnaldos Carrillo M:
Laboratory Medicine Department, Hospital Universitario Virgen de La Arrixaca, Murcia, Spain
González Morales M:
Laboratory Medicine Department, Hospital Universitario Santa Lucía, Cartagena, Spain
Núñez Gárate M:
Catlab. Hospital Universitario Mútua Terrassa, Barcelona, Spain
Ruiz Iruela C:
Laboratory Medicine Department, Fundación Sanitària Hospital de Mollet, Barcelona, Spain
Esteban Torrella P:
Laboratory Medicine Department, Hospital General Universitario Reina Sofía, Murcia, Spain
Vila Pérez M:
Laboratory Medicine Department, Hospital Verge de la Cinta, Tortosa, Tarragona, Spain
Manuel Egea-Caparrós J:
Laboratory Medicine Department, Hospital Universitario Los Arcos del Mar Menor, San Javier, Murcia, Spain
Sáenz L:
Laboratory Medicine Department, Hospital General Universitario Rafael Méndez, Lorca, Murcia, Spain
Galán Ortega A:
Comisión de Magnitudes Biológicas relacionadas con la Urgencia Médica, Sociedad Española de Medicina de Laboratorio (SEQC-ML), Barcelona, Spain
Consuegra-Sánchez L:
Cardiology Department, Hospital Universitario Santa Lucía, Cartagena, Spain
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