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

Larcher, Romaric; Besnard, Noemie; Akouz, Aziz; Rabier, Emmanuelle; Teule, Lauranne; Vandercamere, Thomas; Zozor, Samuel; Amalric, Matthieu; Benomar, Racim; Brunot, Vincent; Corne, Philippe; Barbot, Olivier; Dupuy, Anne-Marie; Cristol, Jean-Paul; Klouche, Kada

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 PaO(2)/FiO(2) 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 PaO(2)/FiO(2) and higher hs-cTnT serum levels. Conclusions: At ICU admission, besides PaO(2)/FiO(2), hs-cTnT levels may allow early risk stratification and triage in critically ill COVID-19 patients.