Relationship of troponins with in-hospital mortality in adults with covid-19 in a colombian caribbean city: a nested case-control study

Abstract

Background: myocardial injury, characterized by elevated cardiac troponin levels, is a common finding in severe COVID-19 cases, occurring in up to 38% of patients. It has been identified as an independent predictor of mortality. Objective: our aim is to assess the predictive value of cardiac troponin levels for in-hospital mortality among adults hospitalized with COVID-19 in Barranquilla, Colombia, during the period from January to June 2021. Methods: this study is a nested case-control analysis within a retrospective cohort. It encompasses individuals aged 18 and older with a confirmed diagnosis of COVID-19 who were hospitalized between January and June 2021 (n = 358). We describe the demographic and paraclinical characteristics of the patients and their association with outcomes at the time of discharge. We also estimate the diagnostic accuracy, including sensitivity, specificity, and predictive values, of elevated troponin levels in predicting in-hospital mortality. Results: patients with elevated troponin levels demonstrated a significantly increased risk of in-hospital mortality (OR: 9.4; 95% CI: 5.5-16.0; p < 0.05) and had a notably higher in-hospital mortality rate (55.6%) compared to those with non-elevated troponin levels (11.7%). The troponin biomarker exhibited a sensitivity of 77.9% and specificity of 72.7%, with positive and negative predictive values of 55.6% and 88.3%, respectively, for in-hospital mortality. Conclusion: troponin elevation in subjects with COVID-19 is positively related to in-hospital mortality, independently of other conditions such as age group, comorbidities, or oxygen therapy requirement.