Background:
Recent studies have demonstrated the impact of elevated cardiac troponin-T (cTnT) levels and the presence of cardiovascular comorbidities on the prognosis of patients with COVID-19, however, the Brazilian population has been underrepresented in these studies. Our study evaluates the correlation of cTnT levels with comorbidities and in-hospital outcomes in patients with COVID-19 in Brazil.
Methods:
Data from a cohort of 3777 patients admitted with COVID-19 in a Brazilian tertiary center, between March and August 2020, were reviewed. 2531 (67%) patients had cTnT determined in the first 24 hours of admission and were stratified into two groups: elevated cTnT (> 0.014 ng/ml) and normal cTnT. Associations between troponin, comorbidities, biomarkers and outcomes were assessed. Regression models were built to assess the association of several variables with in-hospital mortality.
Results:
1373 (54%) men, with a mean age of 59 ± 17 years, were embraced. 971 (38%) had normal cTnT and 1560 (62%) had elevated cTnT. Patients with elevated cTnT were older (63 ± 16 vs 52 ± 16 years, P<0.001) and had more comorbidities, such as cardiovascular disease, hypertension, diabetes, smoking, arrhythmia, renal dysfunction, liver disease, stroke, cancer and dementia (P<0.001). Patients with abnormal cTnT also had significantly (P<0.001) altered laboratory parameters on admission (leukocytes, C-reactive protein, D-dimer and BNP) as well as more need for ICU, vasoactive drugs, mechanical ventilation, dialysis, and blood transfusion. All-cause mortality was higher among patients with increased cTnT than those with normal levels (42% vs 16%, P<0.001). Multiple regression analysis demonstrated that in-hospital mortality was independently associated with hypertension (P<0.003), dialysis (P<0.001), age above 70 years (P=0.004) and obesity (P=0.018); but not with troponin elevation (P=0.161), nor when considering higher values (>3x upper limit of normality, P=0.076).
Conclusion:
Admissional cTnT elevation was common and associated with several comorbidities, biomarkers and clinical outcomes in patients hospitalized with COVID-19, but was not an independent marker of in-hospital mortality.
Footnotes
Poster Contributions
For exact presentation time, refer to the online ACC.22 Program Planner at https://www.abstractsonline.com/pp8/#!/10461
Session Title: Spotlight on Special Topics Flatboard Poster Selections: COVID
Abstract Category: 61. Spotlight on Special Topics: Coronavirus Disease (COVID-19)