Gender-Related Prognostic Value of Cardiac Troponin-I in Covid-19 Patients

Öz

Objective: Cardiac troponin levels can be increased in many cardiac and non-cardiac diseases. In our study, we aimed to measure the troponin-I level of COVID-19 patients at admission to the hospital to determine its ability to predict the intensive care need and all-cause mortality risk and to evaluate its relationship with gender.

Material and Methods: The study was carried out retrospectively by analyzing the electronic medical records of COVID-19 patients who were hospitalized in our hospital between April 1, 2020 and February 1, 2021 and were tested for cardiac troponin-I in the first 24 hours. Statistical analysis was performed for all variables investigated in the study.

Results: A total of 362 COVID patients were included in the study. Cardiac troponin-I level was abnormal in 90 patients. In 39 of the patients, the need for intensive care developed. Cardiac troponin-I level was abnormal in 17 of the patients in need of intensive care and in 73 of the patients who were not followed up in intensive care unit. It was observed that the need for intensive care was 71% higher in male gender and the negative predictive value of cardiac troponin-I level was 87.5%. Cardiac troponin-I level was abnormal in 11 of the patients who died and in 79 of the patients who survived. It was determined that the mortality risk was 75% higher in the male gender and the negative predictive value of cardiac troponin-I level was 91.7%.

Conclusion: In this study, it was observed that normal troponin level in the first 24 hours of hospitalization has a high negative predictive value for mortality in men and women. It was thought that cardiac troponin-I levels could be a guiding biomarker for clinicians in the follow-up of COVID-19 patients, and patients with normal cardiac troponin-I could be discharged earlier than other patients.

Anahtar Kelimeler

• COVID-19
• Troponin I
• Prognosis

COVID-19 HASTALARINDA KARDİYAK TROPONİN-I’NIN CİNSİYET İLİŞKİLİ PROGNOSTİK DEĞERİ

Öz

Amaç: Kardiyak troponinler kardiyak ve non-kardiak birçok hastalıkta yükselebilmektedir. Çalışmamızda COVID-19 hastalarının hastaneye kabulünde kardiyak troponin-I seviyesinin yoğun bakım ihtiyacı ve tüm nedenlere bağlı mortalite riskini önceden tahmin etme kabiliyetinin belirlenmesi ve cinsiyet ile ilişkisinin değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntemler: Çalışma, hastanemizde 1 Nisan 2020 ile 1 Şubat 2021 tarihleri arasında yatırılan ve ilk 24 saatteki kardiyak troponin-I bakılmış COVID-19 hastalarının elektronik tıbbi kayıtlarının retrospektif olarak analiz edilmesi ile yapıldı. Çalışmada araştırılan tüm değişkenler için istatistiksel analiz yapıldı.

Bulgular: Çalışmaya toplam 362 COVID hastası dahil edildi. 90 hastada kardiyak troponin-I düzeyi anormaldi. Hastaların 39'unda yoğun bakım ihtiyacı gelişti. Yoğun bakıma ihtiyaç duyan hastaların 17'sinde, yoğun bakım ünitesinde takip edilmeyen hastaların 73'ünde kardiyak troponin-I düzeyi anormaldi. Erkek cinsiyette yoğun bakım ihtiyacının %71 daha fazla olduğu ve kardiyak troponin-I düzeyinin negatif prediktif değerinin %87,5 olduğu görüldü. Kardiyak troponin-I düzeyi ölen hastaların 11'inde, sağ kalan hastaların 79'unda anormaldi. Erkek cinsiyette ölüm riskinin %75 daha yüksek olduğu ve kardiyak troponin-I düzeyinin negatif prediktif değerinin %91,7 olduğu belirlendi.

Sonuç: Bu çalışmada, hastaneye yatışın ilk 24 saatindeki normal troponin seviyesinin, mortalite için kadın ve erkek cinsiyette yüksek negatif prediktif değere sahip olduğu görülmüştür. Kardiyak troponin-I seviyelerinin COVID-19 hasta takibinde klinisyenlere yol gösterici bir biyobelirteç olabileceği ve kardiyak troponin-I seviyesi normal olan hastaların diğer hastalara göre daha erken taburcu edilebileceği düşünülmüştür.

Anahtar Kelimeler

• COVID-19
• Troponin I
• Prognoz

Kaynakça

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