engleski

Cardiac troponins predict mortality in patients with COVID-19: A meta-analysis of adjusted risk estimates

Critical illness and sepsis are often associated with a troponin rise. Therefore, troponin, in daily clinical practice, is frequently used as a marker of disease severity and as a predictor of future unfavourable outcomes. Recently, several studies investigated the prognostic role of biomarkers of myocardial injury (i.e. troponins) with mortality in hospitalized patients with coronavirus disease 2019 (COVID-19). Of note, those meta-analyses included studies that reported primarily unadjusted effect estimates of in- hospital mortality with higher troponin levels. Compared to patients with normal troponin levels, those with elevated troponins and consequently worse outcome were older and had higher rates of comorbidities including coronary artery disease, hypertension, chronic kidney disease, and diabetes. As a consequence, the final results of those studies showed a significant heterogeneity and markedly different risk estimates of mortality .Therefore, we systematically searched Medline and Scopus to identify all observational cohort studies that compared outcome (in-hospital mortality) in consecutive patients hospitalized with COVID-19 with and without troponin elevation. A meta-analysis of studies that reported adjusted effect estimates was conducted using the generic inverse variance method, and heterogeneity between studies was investigated using the Cochrane‘s Q test and I2 statistic. Publication bias was assessed graphically using a funnel plot. From these we concluded that troponin positivity is common in hospitalised COVID-19 patients, and may serve as an additional risk stratification tool in everyday clinical setting.

troponin ; mortality ; CoVID 19 ; meta-analysis

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