Background: The clinical significance of cardiac troponin measurement in patients hospitalised for coronavirus disease 2019 (covid-19) is uncertain. We investigated the prevalence of elevated troponins in these patients and its prognostic value for predicting mortality.
Methods: Studies were identified by searching electronic databases and preprint servers. We included studies of hospitalised covid-19 patients that reported the frequency of troponin elevations above the upper reference limit and/or the association between troponins and mortality. Meta-analyses were performed using random-effects models.
Results: Fifty-one studies were included. Elevated troponins were found in 20.8% (95% confidence interval [CI] 16.8-25.0 %) of patients who received troponin test on hospital admission. Elevated troponins on admission were associated with a higher risk of subsequent death (risk ratio 2.68, 95% CI 2.08-3.46) after adjusting for confounders in multivariable analysis. The pooled sensitivity of elevated admission troponins for predicting death was 0.60 (95% CI 0.54-0.65), and the specificity was 0.83 (0.77-0.88). The post-test probability of death was about 42% for patients with elevated admission troponins and was about 9% for those with non-elevated troponins on admission. There was significant heterogeneity in the analyses, and many included studies were at risk of bias due to the lack of systematic troponin measurement and inadequate follow-up.
Conclusion: Elevated troponins were relatively common in patients hospitalised for covid-19. Troponin measurement on admission might help in risk stratification, especially in identifying patients at high risk of death when troponin levels are elevated. High-quality prospective studies are needed to validate these findings.
Systematic Review Registration: PROSPERO CRD42020176747.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7682759 | PMC |
| http://dx.doi.org/10.1186/s40560-020-00508-6 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Dynamics of troponins and 30-day mortality in hospitalized patients with pulmonary embolism.
Thromb Res
January 2025
Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark; Department of Data, Biostatistics and Pharmacoepidemiology, Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Denmark.
Background: In patients with pulmonary embolism (PE), the impact of repeated troponin I or T (TnI/TnT) measurements remains unclear.
Methods: Using Danish national registries, we identified PE patients (≥18 years) hospitalized between 2013 and 2018 with initial TnI or TnT measurement within -1/+1 day from admission and >1 repeated measurement within three days. Trajectories of TnI and TnT were identified using latent class trajectory modeling.
Machine-learning based risk prediction of outcomes in patients hospitalised with COVID-19 in Australia: the AUS-COVID score.
J Am Med Inform Assoc
January 2025
Department of Cardiology, Royal North Shore Hospital, Sydney, NSW, Australia.
Objective: We aimed to develop a highly interpretable and effective, machine-learning based risk prediction algorithm to predict in-hospital mortality, intubation and adverse cardiovascular events in patients hospitalised with COVID-19 in Australia (AUS-COVID Score).
Materials And Methods: This prospective study across 21 hospitals included 1714 consecutive patients aged ≥ 18 in their index hospitalization with COVID-19. The dataset was separated into training (80%) and test sets (20%).
Blood Biomarkers as a Non-Invasive Method for the Assessment of the State of the Fontan Circulation.
J Clin Med
January 2025
Department of Preventive Cardiology and Lipidology, Medical University of Lodz, 90-419 Lodz, Poland.
The Fontan operation has become the primary palliative treatment for patients with a functionally univentricular heart. The population of patients with Fontan circulation is constantly growing and aging. As the number of Fontan patients surviving into adulthood increases, there is a clear need for research on how best to follow these patients and manage their complications.
View Article and Find Full Text PDFLeft Ventricular Hypertrabeculation (LVHT) in Athletes: A Negligible Finding?
Medicina (Kaunas)
December 2024
Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, LT-03225 Vilnius, Lithuania.
Left ventricular hypertrabeculation (LVHT) used to be a rare phenotypic trait. With advances in diagnostic imaging techniques, LVHT is being recognised in an increasing number of people. The scientific data show the possibility of the overdiagnosis of this cardiomyopathy in a population of people who have very high levels of physical activity.
View Article and Find Full Text PDFPre-Hospital Point-of-Care Troponin: Is It Possible to Anticipate the Diagnosis? A Preliminary Report.
Diagnostics (Basel)
January 2025
UOC Emergenza Territoriale 118 Area Provinciale Aretina, Azienda USL Toscana Sud-Est, 52100 Arezzo, Italy.
: Thanks to the evolution of laboratory medicine, point-of-care testing (POCT) for troponin levels in the blood (hs-cTn) has been greatly improved in order to quickly diagnose acute myocardial infarction (AMI) with an accuracy similar to standard laboratory tests. The rationale of the HEART POCT study is to propose the application of the 0/1 h European Society of Cardiology (ESC) algorithm in the pre-hospital setting using a POCT device (Atellica VTLi). : This is a prospective study comparing patients who underwent pre-hospital point-of-care troponin testing (Atellica VTLi) with a control group that underwent standard hospital-based troponin testing (Elecsys).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!