Admission High-Sensitive Cardiac Troponin T Level Increase Is Independently Associated with Higher Mortality in Critically Ill Patients with COVID-19: A Multicenter Study

R. Larcher (1, 2) , Noemie Besnard (2) , Aziz Akouz (3) , Emmanuelle Rabier , Lauranne Teule (3) , Thomas Vandercamere , Samuel Zozor (2) , Matthieu Amalric (2) , Racim Benomar (2) , Vincent Brunot (2, 4) , Philippe Corne (3) , Olivier Barbot , Anne-Marie Dupuy (2, 5) , Jean-Paul Cristol (1, 2) , Kada Klouche (1, 2)

1 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
2 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
3 Centre Hospitalier Saint Jean de Perpignan
4 UM - Université de Montpellier
5 INM - Institut des Neurosciences de Montpellier

Background: In coronavirus disease 2019 (COVID-19) patients, increases in high-sensitive cardiac troponin T (hs-cTnT) have been reported to be associated with worse outcomes. In the critically ill, the prognostic value of hs-cTnT, however, remains to be assessed given that most previous studies have involved a case mix of non- and severely ill COVID-19 patients. Methods: We conducted, from March to May 2020, in three French intensive care units (ICUs), a multicenter retrospective cohort study to assess in-hospital mortality predictability of hs-cTnT levels in COVID-19 patients. Results: 111 laboratory-confirmed COVID-19 patients (68% of male, median age 67 (58–75) years old) were included. At ICU admission, the median Charlson Index, Simplified Acute Physiology Score II, and PaO2/FiO2 were at 3 (2–5), 37 (27–48), and 140 (98–154), respectively, and the median hs-cTnT serum levels were at 16.0 (10.1–31.9) ng/L. Seventy-five patients (68%) were mechanically ventilated, 41 (37%) were treated with norepinephrine, and 17 (15%) underwent renal replacement therapy. In-hospital mortality was 29% (32/111) and was independently associated with lower PaO2/FiO2 and higher hs-cTnT serum levels. Conclusions: At ICU admission, besides PaO2/FiO2, hs-cTnT levels may allow early risk stratification and triage in critically ill COVID-19 patients.

Mots clés: Covid-19; ICU; SARS-CoV-2; High-sensitive cardiac troponin T.; Myocardial injury; Outcomes

Domaines: Sciences du Vivant [q-bio]

R. Larcher, Noemie Besnard, Aziz Akouz, Emmanuelle Rabier, Lauranne Teule, et al.. Admission High-Sensitive Cardiac Troponin T Level Increase Is Independently Associated with Higher Mortality in Critically Ill Patients with COVID-19: A Multicenter Study. Journal of Clinical Medicine, 2021, 10 (8), pp.1656. ⟨10.3390/jcm10081656⟩. ⟨hal-03214297⟩