Troponin elevation and prognosis in hospitalized patients with COVID-19. RACCOVID-19 Registry data

Background: Coronavirus disease (COVID-19) is one of the largest pandemics known to date. Elevated troponin can be caused by multiple factors, but its increase is related to adverse outcomes and higher mortality. In the First Argentine Registry of Cardiac Complications in patients with COVID-19 (RACCOVID-19) the Argentine Society of Cardiology (SAC) and the Argentine Federation of Cardiology (FAC) data were analyzed. Objectives: The aim of this study was to learn the troponin elevation rate and its relationship with the prognosis of patients included into the RACCOVID-19. Methods: A total of 2750 patients were included in 50 centers in 11 provinces of the country from May 18 to October 31, 2020. Results: Troponin samples were taken from 2378 patients. The positivity rate was 15.2%. The most common cause of troponin elevation was related to infection (inflammatory) followed by heart failure. The group of patients with elevated troponin showed a higher age, predominant male sex, higher rate of history of asthma/COPD, diabetes mellitus, kidney failure and/or dialysis, and more severe forms of COVID-19. Mortality in the registry was 19.3% and 43.3% in patients with troponin elevation (43.8% vs. 13.9%, p < 0.001). Troponin elevation was independently associated with mortality. Conclusions: The RACCOVID-19 registry showed a troponin positivity rate of 15.2%. These patients presented more comorbidities and more severe forms of the disease. The increase in troponin during hospitalization for COVID-19 is independently associated with higher mortality.