Cardiac Troponin-I and COVID-19: a prognostic tool for in-hospital mortality

Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused Coronavirus disease 2019 (COVID-19) emerging outbreak. In up to 15% of cases, the clinical course of the disease may get complicated to a severe form of interstitial pneumonia, acute respiratory distress syndrome (ARDS) and/or multi-organ failure (MOF) and death. So, our cross-sectional study was conducted to evaluate cardiac troponin I as a prognostic factor for poor in-hospital outcome in patients admitted with COVID-19 infection. Methods Study included 101 confirmed COVID-19 patients with age > 18 years old, of any gender, survivors (74 patients) and non-survivors (27 patients), with no history of any cardiac or pulmonary disease. They were subjected to medical history, clinical examination and laboratory investigations including cardiac troponin I, CBC, urea, creatinine, AST, ALT, CRP, D-Dimer, INR, Na, K and ABG. During their hospital stay, a comparison was done among all sociodemographic data, vital signs on admission, laboratory findings including troponin I level, clinical outcome (need for mechanical ventilation and length of mechanical ventilation if needed), CT chest, CORADS score and APACHI II score between both groups. Results The mean troponin levels showed statistically significant difference between COVID-19 survivors and non-survivors (P-value = 0.001). Significant lower number of survivors needed mechanical ventilation compared to the non survivors (p-value <0.001). The non-survivors group has significantly higher APACHE II score compared to the survivors group (p-value <0.001). At the cutoff point of 0.65 the sensitivity of troponin I as a predictor of mortality in COVID-19 patients is 63.0% and the specificity is 90.5%. Conclusion Cardiac Troponin I is a good prognostic factor for poor in-hospital outcomes among COVID-19 patients; it can predict the need for mechanical ventilation and the in-hospital mortality, however it couldn't predict the length of mechanical ventilation among those patients.

Automated summary

This study aimed to evaluate cardiac troponin I as a predictive factor for poor in-hospital outcomes in COVID-19 patients. The results showed that there was a significant difference in troponin levels between COVID-19 survivors and non-survivors, with a higher proportion of non-survivors requiring mechanical ventilation and a higher APACHE II score in the non-survivors group. Therefore, cardiac troponin I is a good prognostic factor for poor in-hospital outcomes among COVID-19 patients.