Troponin and short-term mortality in hospitalised patients with COVID-19 infection: a retrospective study in an inner-city London hospital.

Abstract

To investigate the association between troponin positivity in patients hospitalised with COVID-19 and increased mortality in the short term. Homerton University Hospital, an inner-city district general hospital in East London. A single-centre retrospective observational study. All adults admitted with swab-proven RT-PCR COVID-19 to Homerton University Hospital from 4 February 2020 to 30 April 2020 (n=402). We analysed demographic and biochemical data collected from the patient record according to the primary outcome of death at 28 days during hospital admission. Troponin positivity was defined above the upper limit of normal according to our local laboratory assay (>15.5 ng/L for females, >34 ng/L for males). Univariate and multivariate logistical regression analyses were performed to evaluate the link between troponin positivity and death. Mean age was 65.3 years for men compared with 63.8 years for women. A χ² test showed survival of patients with COVID-19 was significantly higher in those with a negative troponin (p=3.23×10^-10) compared with those with a positive troponin. In the multivariate logistical regression, lung disease, age, troponin positivity and continuous positive airway pressure were all significantly associated with death, with an area under the curve of 0.889, sensitivity of 0.886 and specificity of 0.629 for the model. Within this model, troponin positivity was independently associated with short-term mortality (OR 2.97, 95% CI 1.34 to 6.61, p=0.008). We demonstrated an independent association between troponin positivity and increased short-term mortality in COVID-19 in a London district general hospital.