- Mild myocardial injury is common in patients with COVID-19.
- Higher troponin elevations correlate with higher mortality risk.
Why this matters
- Case series have reported that cardiac injury is associated with COVID-19.
- Little is known about how SARS-CoV-2 affects the heart and clinical outcomes.
- Median age: 66.4 years.
- 24% had a history of cardiovascular disease (CVD).
- 36% had elevated troponin.
- As troponin rose, so did illness severity as measured by CURB-65 scores.
- Compared with patients with lower troponins, in patients with higher troponin elevations:
- CVD prevalence was higher.
- Levels of D-dimer, C-reactive protein, lactate dehydrogenase, and procalcitonin were higher.
- Many patients with higher troponin levels did not show evidence of primary acute myocardial infarction.
- Mortality vs troponin levels in reference range:
- Troponin >0.03 to 0.09 ng/mL: adjusted HR, 1.75 (95% CI, 1.37-2.24).
- Troponin >0.09 ng/mL: adjusted HR, 3.03 (95% CI, 2.42-3.80).
- Retrospective 5-hospital study in New York City of COVID-19 in patients who underwent troponin I measurement within 24 hours of admission (n=2736).
- Outcome: mortality.
- Funding: NIH.
- Electrocardiograms were not reviewed.
- Etiology of cardiac injury remains unclear.