High troponin levels in patients hospitalized for coronavirus disease 2019: a maker or a marker of prognosis?

AIMS: Controversial data have been published regarding the prognostic role of cardiac troponins in patients who need hospitalization because of coronavirus disease 2019 (COVID-19). The aim of the study was to assess the role of high-sensitivity troponin plasma levels and of respiratory function at admission on all-cause deaths in unselected patients hospitalized because of COVID-19. METHODS: We pooled individual patient data from observational studies that assessed all-cause mortality of unselected patients hospitalized for COVID-19. The individual data of 722 patients were included. The ratio of partial pressure arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) and high-sensitivity troponins was reported at admission in all patients. This meta-analysis was registered on PROSPERO (CRD42020213209). RESULTS: After a median follow-up of 14 days, 180 deaths were observed. At multivariable regression analysis, age [hazard ratio (HR) 1.083, 95% confidence interval (CI) 1.061-1.105, P  < 0.0001], male sex (hr 2.049, 95% ci 1.319-3.184, p =" 0.0133)" moderate-severe renal dysfunction (estimated glomerular filtration rate  < 30 ml min m2) 2.108, 1.237-3.594, and lower pao2 fio2 0.901, 0.829-0.978, were the independent predictors of death. a linear increase in hr was associated with decreasing values below normality threshold. on contrary, curve for troponin plasma levels near-flat large above thresholds. conclusion: in unselected patients hospitalized covid-19, mortality is mainly driven by gender, older age respiratory failure. elevated high-sensitivity troponins are not an predictor worse survival when function accounted for.< div>