IMPACT OF ADMISSION TROPONIN AND TROPONIN RISE DURING HOSPITALIZATION ON MORTALITY IN COVID-19 PNEUMONIA WITH ACUTE RESPIRATORY FAILURE

2021 
TOPIC: Chest Infections TYPE: Original Investigations PURPOSE: COVID-19 can cause multi-organ failure and death. Troponin levels may be elevated in such patients from demand ischemia due to hypoxia versus direct myocardial injury. The information regarding association between troponin levels and mortality is limited in COVID 19 patients. In our study, we specifically determined the correlation of admission troponin as well as troponin rise during hospitalization in COVID-19 patients with acute respiratory failure with mortality. METHODS: Medical records of seventy one (71) patients with COVID-19 pneumonia and acute respiratory failure were reviewed to determine demographic features, admission troponin, rise in troponin (peak troponin - admission troponin) and survival. Pearson’s correlation analysis was performed to evaluate the correlation between admission troponin, rise in troponin and mortality. Independent t-test was used to determine the impact of admission troponin on hospital mortality. P < 0.05 was deemed statistically significant. RESULTS: Seventy-three percent (73%) of studied patients were male. Average age was 47.7 ± 16.7 years. Twenty-two percent (22%) of patients expired. Mean admission troponin was: 0.18 ± 1.1 ng/mL. Mean troponin rise (peak troponin - admission troponin) during hospital stay was: 0.7 ± 3.18 ng/mL. Admission troponin in survivors was 0.03 ± 0.04 ng/mL and in non-survivors was: 0.9 ±2.6 ng/mL (p = 0.02, independent t-test). Troponin rise in survivors was 0.7 ± 3.5 ng/mL and in non-survivors was: 0.55 ± 1.6 ng/mL (p=0.8, independent t-test). Pearson’s correlation analysis showed significant correlation between admission troponin and mortality (r = -0.292, p= 0.028) but no correlation between troponin rise and mortality (r = 0.02;p= 0.83). CONCLUSIONS: A higher troponin at admission has a significant correlation with mortality in COVID19 patients with acute respiratory failure. However, there was no significant correlation between rise in troponin levels and mortality which may have been due to a small sample size in our study. CLINICAL IMPLICATIONS: Troponin levels on admission can be utilized to predict outcomes in patients with COVID-19 pneumonia and acute respiratory failure. Further studies need to be done to determine whether a rise in troponin levels can also be predictor of mortality. Future studies can also determine if increased mortality is seen at specific troponin levels in patients with COVID 19 pneumonia DISCLOSURES: No relevant relationships by Debapriya Datta, source=Web Response No relevant relationships by Manasvi Gupta, source=Web Response No relevant relationships by Gaurav Manek, source=Web Response No relevant relationships by Suong Nguyen, source=Web Response
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