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?:abstract
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(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) penetrates the respiratory epithelium through angiotensin-converting enzyme-2 (ACE2) binding Myocardial and endothelial expression of ACE2 could account for the growing body of reported evidence of myocardial injury in severe forms of Human Coronavirus Disease 2019 (COVID-19) We aimed to provide insight into the impact of troponin (hsTnI) elevation on SARS-CoV-2 outcomes in patients hospitalized for COVID-19 (2) Methods: This was a retrospective analysis of hospitalized adult patients with the SARS-CoV-2 infection admitted to a university hospital in France The observation period ended at hospital discharge (3) Results: During the study period, 772 adult, symptomatic COVID-19 patients were hospitalized for more than 24 h in our institution, of whom 375 had a hsTnI measurement and were included in this analysis The median age was 66 (55–74) years, and there were 67% of men Overall, 205 (55%) patients were placed under mechanical ventilation and 90 (24%) died A rise in hsTnI was noted in 34% of the cohort, whereas only three patients had acute coronary syndrome (ACS) and one case of myocarditis Death occurred more frequently in patients with hsTnI elevation (HR 3 95, 95% CI 2 69–5 71) In the multivariate regression model, a rise in hsTnI was independently associated with mortality (OR 3 12, 95% CI 1 49–6 65) as well as age ≥65 years old (OR 3 17, 95% CI 1 45–7 18) and CRP ≥100 mg/L (OR 3 62, 95% CI 1 12–13 98) After performing a sensitivity analysis for the missing values of hsTnI, troponin elevation remained independently and significantly associated with death (OR 3 84, 95% CI 1 78–8 28) (4) Conclusion: Our study showed a four-fold increased risk of death in the case of a rise in hsTnI, underlining the prognostic value of troponin assessment in the COVID-19 context
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