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Normal high-sensitivity cardiac troponin for ruling-out inpatient mortality in acute COVID-19
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dc.contributor.author | Liu, Alexander | |
dc.contributor.author | Hammond, Robert | |
dc.contributor.author | Chan, Kenneth | |
dc.contributor.author | Chukwuenweniwe, Chukwugozie | |
dc.contributor.author | Johnson, Rebecca | |
dc.contributor.author | Khair, Duaa | |
dc.contributor.author | Duck, Eleanor | |
dc.contributor.author | Olubodun, Oluwaseun | |
dc.contributor.author | Barwick, Kristian | |
dc.contributor.author | Banya, Winston | |
dc.contributor.author | Stirrup, James | |
dc.contributor.author | Donnelly, Peter D. | |
dc.contributor.author | Kaski, Juan Carlos | |
dc.contributor.author | Coates, Anthony R. M. | |
dc.date.accessioned | 2023-04-27T08:30:12Z | |
dc.date.available | 2023-04-27T08:30:12Z | |
dc.date.issued | 2023-04-21 | |
dc.identifier | 284975355 | |
dc.identifier | a5007be8-7a3c-4c49-abd1-76250d0d18f7 | |
dc.identifier | 85153545503 | |
dc.identifier.citation | Liu , A , Hammond , R , Chan , K , Chukwuenweniwe , C , Johnson , R , Khair , D , Duck , E , Olubodun , O , Barwick , K , Banya , W , Stirrup , J , Donnelly , P D , Kaski , J C & Coates , A R M 2023 , ' Normal high-sensitivity cardiac troponin for ruling-out inpatient mortality in acute COVID-19 ' , PLoS ONE , vol. 18 , no. 4 , e0284523 . https://doi.org/10.1371/journal.pone.0284523 | en |
dc.identifier.issn | 1932-6203 | |
dc.identifier.other | RIS: urn:942D19530B9823E629401EB9C87705BD | |
dc.identifier.other | ORCID: /0000-0003-3664-3641/work/157140949 | |
dc.identifier.uri | https://hdl.handle.net/10023/27473 | |
dc.description.abstract | Introduction Assessment of inpatient mortality risk in COVID-19 patients is important for guiding clinical decision-making. High sensitivity cardiac troponin T (hs-cTnT) is a biomarker of cardiac injury associated with a worse prognosis in COVID-19. We explored how hs-cTnT could potentially be used in clinical practice for ruling in and ruling out mortality in COVID-19. Method We tested the diagnostic value of hs-cTnT in laboratory-confirmed COVID-19 patients (≥18 years old) admitted to the Royal Berkshire Hospital (UK) between 1st March and 10th May 2020. A normal hs-cTnT was defined as a value within the 99th percentile of healthy individuals (≤14 ng/L), and an elevated hs-cTnT was defined as >14 ng/L. Adverse clinical outcome was defined as inpatient mortality related to COVID-19. Results A total of 191 COVID-19 patients (62% male; age 66±16 years) had hs-cTnT measured on admission. Of these patients, 124 (65%) had elevated hs-cTnT and 67 (35%) had normal hs-cTnT. On a group level, patients with elevated hs-cTnT had worse inpatient survival (p = 0.0014; Kaplan-Meier analysis) and higher risk of inpatient mortality (HR 5.84 [95% CI 1.29–26.4]; p = 0.02; Cox multivariate regression) compared to patients with normal hs-cTnT. On a per-patient level, a normal hs-cTnT had a negative predictive value of 94% (95% CI: 85–98%) for ruling out mortality, whilst an elevated hs-cTnT had a low positive predictive value of 38% (95% CI: 39–47%) for ruling in mortality. Conclusions In this study cohort of COVID-19 patients, the potential clinical utility of hs-cTnT appears to rest in ruling out inpatient mortality. This finding, if prospectively validated in a larger study, may allow hs-cTnT to become an important biomarker to facilitate admission-avoidance and early safe discharge. | |
dc.format.extent | 15 | |
dc.format.extent | 1202869 | |
dc.language.iso | eng | |
dc.relation.ispartof | PLoS ONE | en |
dc.subject | COVID-19 | en |
dc.subject | RA0421 Public health. Hygiene. Preventive Medicine | en |
dc.subject | E-DAS | en |
dc.subject | SDG 3 - Good Health and Well-being | en |
dc.subject | MCC | en |
dc.subject.lcc | RA0421 | en |
dc.title | Normal high-sensitivity cardiac troponin for ruling-out inpatient mortality in acute COVID-19 | en |
dc.type | Journal article | en |
dc.contributor.institution | University of St Andrews. School of Medicine | en |
dc.contributor.institution | University of St Andrews. Infection and Global Health Division | en |
dc.identifier.doi | https://doi.org/10.1371/journal.pone.0284523 | |
dc.description.status | Peer reviewed | en |
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