Prognostic Value of Troponin Elevation in COVID-19 Hospitalized Patients.
Prognostic Value of Troponin Elevation in COVID-19 Hospitalized Patients.
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DOI：
10.3390/jcm9124078
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发表时间：
2020-12-17
影响因子：
3.9
通讯作者：
Stephan D
中科院分区：
文献类型：
--
作者：
Cordeanu EM;Duthil N;Severac F;Lambach H;Tousch J;Jambert L;Mirea C;Delatte A;Younes W;Frantz AS;Merdji H;Schini-Kerth V;Bilbault P;Ohlmann P;Andres E;Stephan D
(1)背景：严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)通过与血管紧张素转换酶-2(ACE2)结合进入呼吸道上皮细胞。心肌和内皮细胞血管紧张素转换酶2的表达可以解释越来越多的报道证据，证明在2019年严重形式的人类冠状病毒病(新冠肺炎)中存在心肌损伤。我们的目的是深入了解肌钙蛋白(HsTnI)升高对因新冠肺炎住院的患者SARS-CoV-2结局的影响。(2)方法：对法国某大学医院收治的成人SARS-CoV-2感染病例进行回顾性分析。观察期在出院时结束。(3)结果：在研究期间，772例成年有症状的新冠肺炎患者住院超过24小时，其中375例进行了hsTnI测定并纳入本研究。年龄中位数为66岁(55-74岁)，男性占67%。总体而言，205名患者(55%)接受了机械通气，90名患者(24%)死亡。队列中有34%的患者hsTnI升高，而只有3名患者患有急性冠脉综合征(ACS)，1名患者患有心肌炎。HsTnI升高的患者死亡发生率较高(HR 3.95，95%CI 2.69~5.71)。在多因素回归模型中，hsTnI升高与病死率(OR3.12，95%CI1.49~6.65)、年龄(OR3.17，95%CI1.45~7.18)和≥≥100 mg/L(OR3.62，95%CI1.12~13.98)独立相关。在对hsTnI缺失值进行敏感性分析后，肌钙蛋白升高仍然是独立的且与死亡显著相关(OR 3.84，95%CI 1.78-8.28)。(4)结论：我们的研究显示，在hsTnI升高的情况下，死亡风险增加四倍，这突显了肌钙蛋白评估在新冠肺炎背景下的预后价值。
(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) penetrates the respiratory epithelium through angiotensin-converting enzyme-2 (ACE2) binding. Myocardial and endothelial expression of ACE2 could account for the growing body of reported evidence of myocardial injury in severe forms of Human Coronavirus Disease 2019 (COVID-19). We aimed to provide insight into the impact of troponin (hsTnI) elevation on SARS-CoV-2 outcomes in patients hospitalized for COVID-19. (2) Methods: This was a retrospective analysis of hospitalized adult patients with the SARS-CoV-2 infection admitted to a university hospital in France. The observation period ended at hospital discharge. (3) Results: During the study period, 772 adult, symptomatic COVID-19 patients were hospitalized for more than 24 h in our institution, of whom 375 had a hsTnI measurement and were included in this analysis. The median age was 66 (55–74) years, and there were 67% of men. Overall, 205 (55%) patients were placed under mechanical ventilation and 90 (24%) died. A rise in hsTnI was noted in 34% of the cohort, whereas only three patients had acute coronary syndrome (ACS) and one case of myocarditis. Death occurred more frequently in patients with hsTnI elevation (HR 3.95, 95% CI 2.69–5.71). In the multivariate regression model, a rise in hsTnI was independently associated with mortality (OR 3.12, 95% CI 1.49–6.65) as well as age ≥ 65 years old (OR 3.17, 95% CI 1.45–7.18) and CRP ≥ 100 mg/L (OR 3.62, 95% CI 1.12–13.98). After performing a sensitivity analysis for the missing values of hsTnI, troponin elevation remained independently and significantly associated with death (OR 3.84, 95% CI 1.78–8.28). (4) Conclusion: Our study showed a four-fold increased risk of death in the case of a rise in hsTnI, underlining the prognostic value of troponin assessment in the COVID-19 context.
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影响因子：
2.6
作者：
Almeida Junior GLG;Braga F;Jorge JK;Nobre GF;Kalichsztein M;Faria PMP;Bussade B;Penna GL;Alves VO;Pereira MA;Gorgulho PC;Faria MRDSE;Drumond LE;Carpinete FBS;Neno ACLB;Neno ACA
通讯作者：
Neno ACA
影响因子：
3.9
作者：
Pedersen AB;Mikkelsen EM;Cronin-Fenton D;Kristensen NR;Pham TM;Pedersen L;Petersen I
通讯作者：
Petersen I
影响因子：
5.7
作者：
Samavati, Lobelia;Uhal, Bruce D.
通讯作者：
Uhal, Bruce D.
影响因子：
56.9
作者：
Yan, Renhong;Zhang, Yuanyuan;Zhou, Qiang
通讯作者：
Zhou, Qiang
影响因子：
24
作者：
Giustino G;Croft LB;Stefanini GG;Bragato R;Silbiger JJ;Vicenzi M;Danilov T;Kukar N;Shaban N;Kini A;Camaj A;Bienstock SW;Rashed ER;Rahman K;Oates CP;Buckley S;Elbaum LS;Arkonac D;Fiter R;Singh R;Li E;Razuk V;Robinson SE;Miller M;Bier B;Donghi V;Pisaniello M;Mantovani R;Pinto G;Rota I;Baggio S;Chiarito M;Fazzari F;Cusmano I;Curzi M;Ro R;Malick W;Kamran M;Kohli-Seth R;Bassily-Marcus AM;Neibart E;Serrao G;Perk G;Mancini D;Reddy VY;Pinney SP;Dangas G;Blasi F;Sharma SK;Mehran R;Condorelli G;Stone GW;Fuster V;Lerakis S;Goldman ME
通讯作者：
Goldman ME