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Prognostic value of troponin elevation at admission and during monitoring in COVID-19 patients

1Hôpital Européen Georges Pompidou, Paris, Paris, Ile-de-France, France, 2Hôpital européen Georges Pompidou, Inserm UMRS_1140, Paris, Ile-de-France, France, 3Université de Paris, Innovative Therapies in Haemostasis, INSERM, F-75006, Paris, France, Paris, Ile-de-France, France, 4Innovative Therapies in Haemostasis, INSERM, Université de Paris, Paris, France, Paris, Ile-de-France, France, 5HEGP, Inserm UMRS_1140, Paris, Ile-de-France, France, 64Department of Emergency, AP-HP, Georges Pompidou European Hospital, Paris, France, Paris, Ile-de-France, France

Abstract Number: PB0585

Meeting: ISTH 2022 Congress

Theme: COVID and Coagulation » COVID and Coagulation, Basic Science

Background: Troponin seems to be a biological marker of interest in the risk-stratification of COVID 19 at admission, but few studies focus on exploring its prognostic abilities during hospitalization.

Aims: To assess the ability of troponin levels at admission and during follow-up to predict in-hospital mortality in COVID-19 patients.

Methods: Troponin was measured at admission and throughout hospitalization amongst COVID-19 patients. We explored the prognostic ability of baseline troponin and kinetics on COVID-19 patients outcomes using logistic regression and Cox model.

Results: Amongst 399 patients enrolled with confirmed COVID-19, 247 had at least 2 troponin measurements during hospitalization and 319 (80%) survived, while 80 (20%) died during hospitalization. Elevated troponin upon arrival was significantly associated with mortality (Odds Ratio (OR) 5.65 (95% CI 3.24 – 9.88); p < 0.01). Patients with an elevated troponin level and underlying cardiovascular diseases were more likely to experience death than those without elevated troponin nor cardiovascular history (Hazard Ratio 4.62 (1.96-10.91); p < 0.001). There seems to be a level-dependent association between troponin level and in-hospital mortality (p < 0.01). To assess the ability of troponin monitoring during the first 10 days of hospitalization to predict in-hospital mortality we analyzed the ratio of troponin (ROT) between the highest level of troponin and the baseline troponin measurement. An increase over 75% of the ROT was not significantly associated with in hospital mortality (OR 1.02 (95% CI 1.01-1.04); p=0.12). During follow-up, there was no significant differences of in-mortality between patients with constant elevated troponin throughout hospitalization and those who went from a normal to an elevated troponin (p=0.15).

Conclusion(s): For COVID-19 patients, troponin seems to be a relevant factor for in-hospital mortality and risk-stratification at admission but its monitoring during follow-up does not appear to be valuable in predicting disease progression.

To cite this abstract in AMA style:

BEAUVAIS A, Gendron N, Philippe A, VEDIE B, LORIOT M, JUVIN P, Sanchez O, DIEHL J, Smadja D, CHOCRON R. Prognostic value of troponin elevation at admission and during monitoring in COVID-19 patients [abstract]. https://abstracts.isth.org/abstract/prognostic-value-of-troponin-elevation-at-admission-and-during-monitoring-in-covid-19-patients/. Accessed September 21, 2023.

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