Admission High-Sensitive Cardiac Troponin T Level Increase Is Independently Associated with Higher Mortality in Critically Ill Patients with COVID-19: A Multicenter Study
Romaric Larcher, Noémie Besnard, Aziz Akouz, Emmanuelle Rabier, Lauranne Teule, Thomas Vandercamere, Samuel Zozor, Matthieu Amalric, Racim Benomar, Vincent Brunot, P. Corne, Olivier Barbot, Anne‐Marie Dupuy, Jean‐Paul Cristol, Kada Klouche
Abstract
Background: In coronavirus disease 2019 (COVID-19) patients, increases in high-sensitive cardiac troponin T (hs-cTnT) have been reported to be associated with worse outcomes. In the critically ill, the prognostic value of hs-cTnT, however, remains to be assessed given that most previous studies have involved a case mix of non- and severely ill COVID-19 patients. Methods: We conducted, from March to May 2020, in three French intensive care units (ICUs), a multicenter retrospective cohort study to assess in-hospital mortality predictability of hs-cTnT levels in COVID-19 patients. Results: 111 laboratory-confirmed COVID-19 patients (68% of male, median age 67 (58–75) years old) were included. At ICU admission, the median Charlson Index, Simplified Acute Physiology Score II, and PaO2/FiO2 were at 3 (2–5), 37 (27–48), and 140 (98–154), respectively, and the median hs-cTnT serum levels were at 16.0 (10.1–31.9) ng/L. Seventy-five patients (68%) were mechanically ventilated, 41 (37%) were treated with norepinephrine, and 17 (15%) underwent renal replacement therapy. In-hospital mortality was 29% (32/111) and was independently associated with lower PaO2/FiO2 and higher hs-cTnT serum levels. Conclusions: At ICU admission, besides PaO2/FiO2, hs-cTnT levels may allow early risk stratification and triage in critically ill COVID-19 patients.