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.
Highlights
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has spread worldwide, resulting in a dramatic pandemic [1]
Data in the intensive care units (ICUs) population remains scarce, since almost all studies have involved a case mix of non-severe and severe patients, or few ICU patients [16,17,18,19]. The aim of this multicentric study was to assess the prognostic value of high-sensitive cardiac troponin T levels at ICU admission in patients with critical SARS-CoV2 infection
The severity of patients’ illnesses was mainly related to respiratory failure, given that the median PaO2/FiO2 ratio at admission was 140 (98–154) and severe acute respiratory distress syndrome (ARDS) according to the Berlin definition occurred in almost one third of the patients (31%)
Summary
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has spread worldwide, resulting in a dramatic pandemic [1]. Data in the ICU population remains scarce, since almost all studies have involved a case mix of non-severe and severe patients, or few ICU patients [16,17,18,19]. The aim of this multicentric study was to assess the prognostic value of high-sensitive cardiac troponin T (hs-cTnT) levels at ICU admission in patients with critical SARS-CoV2 infection
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