Background
Risk stratification in COVID-19 is crucial to optimise treatment strategies. We evaluated the use of biomarkers on admission to hospital and the impact on mortality and morbidity.
Methods
Consecutive patients with COVID-19(PCR+) were included in this retrospective, observational study. 1675 patients were PCR+ and 1036 had a high sensitivity troponin T(hsTropT) on admission. 371 patients were hsTropT-(<15ng/L), 664 were in the myocardial injury group(MIG; hsTropT ≥15ng/L). Baseline data was compared, as were primary outcomes of death, ICU admission and COVID severity. Secondary outcomes included ARDS, myocardial infarction (MI); comparison with biomarkers: NT- proBNP, d-dimer, CRP, LDH and ferritin.
Results
MIG patients were older(75±14v55±14yrs;p<0.001), had more comorbidities eg. diabetes(37v13%), hypertension(34v29%), ischemic heart disease(16v2%)[p<0.01]. Mortality was higher in the MIG(46v8%;p<0.001), as was critical COVID (47v19%;p<0.001), ARDS(20v4%;p<0.001), and Type1 MI(1.6v0.01%;p<0.01). Analysis of biomarkers on admission (Fig 1.) demonstrated hsTropT and NT-proBNP (AUC 0.75 CI 0.69-0.81) sensitvity 83;85% and specificty 52;58%, respectively at predicting death.
Conclusion
Early detection of elevated hsTropT and NT-proBNP predicts mortality and morbidity in patients with COVID-19. Routine measurement of cardiac biomarkers should be considered in these patients at the time of admission in order to optimise risk stratification and monitoring.
Footnotes
Moderated Poster Contributions Saturday, May 15, 2021, 10:30 a.m.-10:40 a.m.
Session Title: Markers to Measure Mortality: Biomarkers, Inflammatory Markers and Other Markers of Outcomes in Patients with COVID-19 Infection
Abstract Category: 61. Spotlight on Special Topics: Coronavirus Disease (COVID-19)
Presentation Number: 1088-07