High-sensitivity troponin in the prognosis of patients hospitalized in intensive care for COVID-19: a Latin American longitudinal cohort study.

Autor: Sprockel J; Serviço de Cuidados Intensivos, Hospital El Tunal, Subred Integrada de Servicios de Salud del Sur - Bogotá, Colômbia.; Instituto de Pesquisa, Fundación Universitaria de Ciencias de la Salud - Bogotá, Colômbia., Murcia A; Serviço de Cuidados Intensivos, Hospital El Tunal, Subred Integrada de Servicios de Salud del Sur - Bogotá, Colômbia., Rincon J; Serviço de Cuidados Intensivos, Hospital El Tunal, Subred Integrada de Servicios de Salud del Sur - Bogotá, Colômbia., Berrio K; Serviço de Cuidados Intensivos, Hospital El Tunal, Subred Integrada de Servicios de Salud del Sur - Bogotá, Colômbia., Bejarano M; Serviço de Cuidados Intensivos, Hospital El Tunal, Subred Integrada de Servicios de Salud del Sur - Bogotá, Colômbia., Santofimio Z; Serviço de Cuidados Intensivos, Hospital El Tunal, Subred Integrada de Servicios de Salud del Sur - Bogotá, Colômbia., Cárdenas H; Serviço de Cuidados Intensivos, Hospital El Tunal, Subred Integrada de Servicios de Salud del Sur - Bogotá, Colômbia., Hernández D; Serviço de Cuidados Intensivos, Hospital El Tunal, Subred Integrada de Servicios de Salud del Sur - Bogotá, Colômbia., Parra J; Serviço de Cuidados Intensivos, Hospital El Tunal, Subred Integrada de Servicios de Salud del Sur - Bogotá, Colômbia.
Jazyk: Portuguese; English
Zdroj: Revista Brasileira de terapia intensiva [Rev Bras Ter Intensiva] 2022 Jan-Mar; Vol. 34 (1), pp. 124-130.
DOI: 10.5935/0103-507X.20220006-pt
Abstrakt: Objective: The current study assessed the prevalence of troponin elevation and its capacity to predict 60day mortality in COVID-19 patients in intensive care.
Methods: A longitudinal prospective single-center study was performed on a cohort of patients in intensive care due to a COVID-19 diagnosis confirmed using real-time test polymerase chain reaction from May to December 2020. A Receiver Operating Characteristic curve was constructed to predict death according to troponin level by calculating the area under the curve and its confidence intervals. A Cox proportional hazards model was generated to report the hazard ratios with confidence intervals of 95% and the p value for its association with 60day mortality.
Results: A total of 296 patients were included with a 51% 60-day mortality rate. Troponin was positive in 39.9% (29.6% versus 49.7% in survivors and non-survivors, respectively). An area under the curve of 0.65 was found (95%CI: 0.59 - 0.71) to predict mortality. The Cox univariate model demonstrated a hazard ratio of 1.94 (95%CI: 1.41 - 2.67) and p < 0.001, but this relationship did not remain in the multivariate model, in which the hazard ratio was 1.387 (95%CI: 0.21 - 1.56) and the p value was 0.12.
Conclusion: Troponin elevation is frequently found in patients in intensive care for COVID-19. Although its levels are higher in patients who die, no relationship was found in a multivariate model, which indicates that troponin should not be used as an only prognostic marker for mortality in this population.
Databáze: MEDLINE
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