Myocardial injury characterized by elevated cardiac troponin and in‐hospital mortality of COVID‐19: an insight from a meta‐analysis

Aikawa, Tadao; Takagi, Hisato; Ishikawa, Kiyotake; Kuno, Toshiki

Elevation of high‐sensitivity cardiac troponin (hs‐cTn) is a surrogate of myocardial injury, which appears to be a common complication of coronavirus disease 2019 (COVID‐19). In this study, a meta‐analysis was performed to clarify the association between myocardial injury assessed by hs‐cTn levels and in‐hospital mortality in patients with COVID‐19. All existing studies on myocardial injury in patients with COVID‐19 were retrieved from PubMed and EMBASE through April 13, 2020. In cases where overlap of the study population or enrollment period was found in articles published from the same hospitals, the article with the largest number of patients was only included in the analysis. The pooled odds ratio was calculated using inverse variance weighted random‐effects models. Six observational studies which included a total of 1,231 patients met the search criteria. The percentage of patients with hs‐cTn levels varied across the studies (13‐41%). Elevated hs‐cTn levels were significantly associated with an increase in in‐hospital mortality (pooled odds ratio, 22.7; 95% confidence interval, 13.6‐38.1; P<0.001) with a moderate heterogeneity (I (2)=28%), suggesting that elevated hs‐cTn levels might be used as a reliable marker of disease severity early in the course of COVID‐19. This article is protected by copyright. All rights reserved.