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Guidelines for Endothelial Testing

High-Sensitivity Cardiac Troponin, An Ally in the Fight Against COVID-19?

Circulation. 2020 Apr 6.
High-Sensitivity Cardiac Troponin Can Be An Ally in the Fight Against COVID-19.
Chapman AR1, Bularga A1, Mills NL2.
1 BHF Centre for Cardiovascular Science, University of Edinburgh, United Kingdom.
2 BHF Centre for Cardiovascular Science, University of Edinburgh, United Kingdom; Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, United Kingdom.
…In a cohort of 191 patients with confirmed COVID-19 based on SARS-CoV-2 RNA detection, the univariable odds ratio for death when hs-cTnI concentrations were above the 99th percentile upper reference limit was 80.1 (95% confidence interval [CI] 10.3 to 620.4, P<0.0001).[4] This was higher than the odds ratios observed for all other biomarkers tested, including D-Dimer and lymphocyte count. A further study of 416 hospitalized patients with COVID-19 reported that cardiac troponin concentrations were elevated in 1 in 5 patients on presentation. These patients were more likely to require invasive or noninvasive ventilation (22% versus 4%, and 46% versus 4%), and to develop acute respiratory distress syndrome (59% versus 15%) or acute kidney injury (9% versus 0%, P<0.001 for all). The observed rate of mortality was 10-fold higher in those with myocardial injury on presentation (51% versus 5%, adjusted hazard ratio 3.41 (95% CI 1.62-7.16).[5] …
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