Frequency of troponin elevations in patients with COVID-19 and clinical course in these patients

Aim: We aimed to determine the frequency of troponin elevations in COVID-19 patients and to investigate the role of troponin in demonstrating the prognosis of COVID-19 by examining the clinical course of theese patients. Material and Method: Patients diagnosed with COVID-19 disease were included in the study. Patient files were analyzed retrospectively through the hospital information management system.Patients with high troponin levels were identified and comparisons were made with patients with normal troponin levels. Results: 1468 patients were included in the study.Troponin level was found to be high in 6.7% of the patients.The presence of pneumonia on thorax CT rate,hospitalization rate,ICU admission rate,intubation rate was significantly higher in patients with high troponin levels.The mortality rate was 2.1% in the whole group.The mortality rate was significantly higher in the patients with high troponin levels.Total length of hospital and ICU stay were significantly higher in patients with high troponin levels.There was a significant positive correlation between the troponin levels of the patients at admission and the total length of hospital stay and length of ICU stay. 49.5% of COVID-19 patients had another comorbid disease.Hypertension was the most common comorbid disease. The rate of troponin elevation and troponin levels were significantly higher in patients with other comorbid diseases. Conclusion: It has been found that high troponin levels in COVID-19 patients may be associated with a poor clinical prognosis. Troponin can be used as a predictor of prognosis with more comprehensive studies and long-term follw-up results in the future.

Keywords:

COVID-19, SARS .CoV-2, troponin cardiac biomarkers, prognosis,

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Alpert JS, Thygesen K, Antman E, Bassand JP. Myocardial infarction redefined—a consensus document of the Joint European ociety of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial Infarction. J Am Coll Cardiol 2000; 36: 959-69
Roffi M, Patrono C, Collet J‐P, et al. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST‐segment elevation: Task Force for the management of acute coronary syndromes in patients presenting without persistent ST‐segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2016; 37: 267–315
Alcalai R, Planer D, Culhaoglu A, Osman A, Pollak A, Lotan C. Acute coronary syndrome vs nonspecific troponin elevation: clinical predictors and survival analysis. Arch Intern Med 2007; 167: 276-81
Wong JA, Goodman SG, Yan RT, et al. Canadian Acute Coronary Syndromes I and II, and Canadian Global Registry of Acute Coronary Events (GRACE/GRACE) Investigators. Temporal management patterns and outcomes of non‐ST elevation acute coronary syndromes in patients with kidney dysfunction. Eur Heart J 2009; 30: 549–57
Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun 2020; 109: 102433
Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents 2020; 55: 105924.
Poutanen SM. Etiologic agents of infectious diseases. In: Long SS, editor. Principles and practice of paediatric infectious diseases. 4th ed. 2012. p. 1547–712.
Pal M, Berhanu G, Desalegn C, Kandi V. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2): an update. Cureus 2020; 12: e7423.
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497–506.
Zhang H, Penninger JM, Li Y, Zhong N, Slutsky AS. Angiotensin-converting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: molecular mechanisms and potential therapeutic target. Intensive Care Med 2020; 46: 586–90 .
Hamming I, Timens W, Bulthuis ML, Lely AT, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol 2004; 203: 631-7.
Alhogbani T. Acute myocarditis associated with novel Middle East respiratory syndrome coronavirus. Ann. Saudi Med 2016; 36: 78–80.
Oudit GY, Kassiri Z, Jiang C, et al. SARS-coronavirus modulation of myocardial ACE2 expression and inflammation in patients with SARS. Eur. J. Clin. Investig 2009; 39: 618–25.
Guo T, Fan Y, Chen M, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA cardiol 2020; 5: 811–8.
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet (London, England) 2020; 395: 1054–62.
Shi S, Qin M, Shen, B, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardio 2020; e200950.
Piccioni A, Brigida M, Loria V, et al. Role of troponin in COVID-19 pandemic: a review of literature. Eur Rev Med Pharmacol Sci 2020; 24: 10293-300.