High-sensitivity cardiac troponin I and D-dimer are risk factors for in-hospital mortality of adult patients with COVID-19: A retrospective cohort study

Abstract

Aim: This study aimed to evaluate the impact of high-sensitivity cardiac troponin I (Hs-cTnI) and D-dimer on in-hospital mortality of adult patients with Coronavirus disease 2019 (COVID-19). Materials and Methods: The COVID-19 outbreak, a global health disaster, has resulted in significant morbidity and mortality around the world since it emerged in December 2019. The outbreak has gradually spread nationwide. COVID-19 is associated with hemostatic abnormalities and cardiac injury. This retrospective cohort study included a total of 221 adult inpatients. The diagnosis of COVID-19 was made according to the World Health Organization's interim guideline and confirmed by RNA detection of SARS-CoV-2. Participants were divided into 2 groups, survivors and non-survivors. Results: Hs-cTnI and D-dimer levels on admission were significantly higher in non-survivors COVID-19 patients (p<0.05 for each). Forward stepwise logistic regression analysis demonstrated that age (OR=1.140, 95% CI: 1.045-1.244, p=0.003), baseline hs-cTnI level (OR=1.022, 95% CI: 1.004-1.041, p=0.018), and baseline D-dimer level (OR=1.790, 95% CI: 1.078-2.972, p=0.024) were independent predictors of in-hospital mortality of adult patients with COVID-19. The receiver operating characteristic curve analysis provided a cut-off value of >18.6 ng/L for hs-cTnI to predict in-hospital mortality of adult patients with COVID-19 with 100% sensitivity and 74% specificity, and a cut-off value of > 1.41 mg/L for D-dimer with 93.3% sensitivity and 71.5% specificity. Conclusion: High-sensitivity cardiac troponin I and D-dimer levels on admission predict in-hospital mortality of adult patients with COVID-19.