The Impact of COVID-19 Patients With Troponin Elevation on Renal Impairment and Clinical Outcome.

The Impact of COVID-19 Patients With Troponin Elevation on Renal Impairment and Clinical Outcome. - 2021

Available in print through MWHC library: 2002 - present

BACKGROUND: Cardiac involvement in coronavirus disease 2019 (COVID-19) is known, manifested by troponin elevation, and these patients have a worse prognosis than patients without myocardial injury. CONCLUSION: COVID-19 patients with troponin elevation are at higher risk for worsening renal function, and these patients subsequently have worse in-hospital clinical outcomes. Efforts should focus on early recognition, evaluation, and intensifying care of these patients. Copyright (c) 2021. Published by Elsevier Inc. METHODS: We analyzed COVID-19-positive patients who presented to the MedStar Health system (11 hospitals in Washington, DC, and Maryland) during the pandemic (March 1-September 30, 2020). We compared renal function and subsequent in-hospital clinical outcomes based on the presence or absence of troponin elevation. The primary outcome was the incidence of acute kidney injury in COVID-19 patients with troponin elevation. We also evaluated in-hospital mortality, overall and based on the presence and absence of both troponin elevation and renal dysfunction. RESULTS: The cohort included 3386 COVID-19-positive admitted patients for whom troponin was drawn. Of these patients, 195 had troponin elevation (defined as >=1.0 ng/mL), mean age was 61 +/- 16 years, and 51% were men. In-hospital mortality was significantly higher (53.8%) in COVID-19-positive patients with concomitant troponin elevation than in those without troponin elevation (14.5%; p < 0.001). COVID-19-positive patients with troponin elevation had a higher prevalence of renal dysfunction (58.5%) than those without troponin elevation (23.4%; p < 0.001). Further analysis demonstrated that having both troponin elevation and renal dysfunction carried the worst in-hospital prognosis (in-hospital mortality 57.9%; intensive-care-unit admission 76.8%; ventilation requirement 63.2%), as compared to the absence or presence of either.


English

1878-0938

10.1016/j.carrev.2021.05.004 [doi] PMC8106189 [pmc] S1553-8389(21)00248-7 [pii]


*COVID-19
Aged
Hospital Mortality
Humans
Male
Middle Aged
Pandemics
Retrospective Studies
SARS-CoV-2
Troponin


MedStar Heart & Vascular Institute
MedStar Washington Hospital Center


Advanced Cardiac Catheterization Research Fellowship
Interventional Cardiology Fellowship


Journal Article

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