Infection and Drug Resistance (Aug 2023)

Elevated High Sensitivity Cardiac Troponin T is Nonlinearly Associated with Poor Prognosis in Aging COVID-19 Patients: A Retrospective Study

  • Jin X,
  • Yang H,
  • Ma W,
  • Yuan Y,
  • Li T

Journal volume & issue
Vol. Volume 16
pp. 5155 – 5163

Abstract

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Xiaxia Jin,1,* Haideng Yang,2,* Weiwei Ma,1,* Yuan Yuan,1 Tao Li3 1Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China; 2Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China; 3Department of Cardiovascular Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuan Yuan, Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, 150 Ximen Road, Linhai, Zhejiang Province, People’s Republic of China, Email [email protected] Tao Li, Department of Cardiovascular Medicine, Taizhou Hospital of Zhejiang Province, 150 Ximen Road, Linhai, Zhejiang Province, People’s Republic of China, Email [email protected]: To evaluate the relationship between high-sensitivity cardiac troponin T (hs-cTnT) and prognosis in elderly patients with coronavirus disease 2019 (COVID-19).Methods: This study recruited 1399 COVID-19 patients aged 65 years or older admitted to Taizhou Hospital or Enze Hospital in Zhejiang Province from December 15, 2022, to January 4, 2023. The Cox regression model was used to evaluate the relationship between hs-cTnT level and in-hospital death. The logistic regression model was used to evaluate the relationship between hs-cTnT level and major adverse events. The restricted cubic spline (RCS) model is used for nonlinear analysis.Results: The increase of peak hs-cTnT was associated with the increased risk of death (HR 9.49; 95% CI 1.19– 75.48; trend p = 0.012) and major adverse events (OR 20.59; 95% CI 10.41– 40.71; trend p < 0.001). RCS model showed the association between peak hs-cTnT and death and major adverse events were nonlinear (P for non-line < 0.001). Starting from the limit of quantification of hs-cTnT (3ng/L), the risk of death and major adverse events had a steep S-shaped increase until hs-cTnT reached the 90th percentile point (hs-cTnT = 131 ng/L), followed by a plateau period. Peak hs-cTnT has good predictive value for death and major adverse events, with AUC of 0.834 and 0.804, respectively.Conclusion: Peak hs-cTnT has high predictive value for the risk of in-hospital death and major adverse events in elderly patients with COVID-19. The association between peak hs-cTnT and death and major adverse events were nonlinear.Keywords: high-sensitivity cardiac troponin T, elderly, COVID-19, nonlinearly, prognosis

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