入院时高敏心肌肌钙蛋白T水平升高与COVID-19危重症患者较高的死亡率独立相关：一项多中心研究。
Admission High-Sensitive Cardiac Troponin T Level Increase Is Independently Associated with Higher Mortality in Critically Ill Patients with COVID-19: A Multicenter Study.
作者信息
Larcher Romaric, Besnard Noemie, Akouz Aziz, Rabier Emmanuelle, Teule Lauranne, Vandercamere Thomas, Zozor Samuel, Amalric Matthieu, Benomar Racim, Brunot Vincent, Corne Philippe, Barbot Olivier, Dupuy Anne-Marie, Cristol Jean-Paul, Klouche Kada
机构信息
Biochemistry and Hormonology Department, Lapeyronie Hospital, University Hospital of Montpellier, 34090 Montpellier, France.
PhyMedExp, University of Montpellier, INSERM, CNRS, Arnaud de Villeneuve Hospital, University Hospital of Montpellier, 34090 Montpellier, France.
出版信息
J Clin Med. 2021 Apr 13;10(8):1656. doi: 10.3390/jcm10081656.
BACKGROUND
In coronavirus disease 2019 (COVID-19) patients, increases in high-sensitive cardiac troponin T (hs-cTnT) have been reported to be associated with worse outcomes. In the critically ill, the prognostic value of hs-cTnT, however, remains to be assessed given that most previous studies have involved a case mix of non- and severely ill COVID-19 patients.
METHODS
We conducted, from March to May 2020, in three French intensive care units (ICUs), a multicenter retrospective cohort study to assess in-hospital mortality predictability of hs-cTnT levels in COVID-19 patients.
RESULTS
111 laboratory-confirmed COVID-19 patients (68% of male, median age 67 (58-75) years old) were included. At ICU admission, the median Charlson Index, Simplified Acute Physiology Score II, and PaO/FiO were at 3 (2-5), 37 (27-48), and 140 (98-154), respectively, and the median hs-cTnT serum levels were at 16.0 (10.1-31.9) ng/L. Seventy-five patients (68%) were mechanically ventilated, 41 (37%) were treated with norepinephrine, and 17 (15%) underwent renal replacement therapy. In-hospital mortality was 29% (32/111) and was independently associated with lower PaO/FiO and higher hs-cTnT serum levels.
CONCLUSIONS
At ICU admission, besides PaO/FiO, hs-cTnT levels may allow early risk stratification and triage in critically ill COVID-19 patients.
背景
在2019冠状病毒病（COVID-19）患者中，据报道高敏心肌肌钙蛋白T（hs-cTnT）升高与更差的预后相关。然而，在重症患者中，鉴于大多数先前的研究纳入了非重症和重症COVID-19患者的混合病例，hs-cTnT的预后价值仍有待评估。
方法
2020年3月至5月，我们在法国的三个重症监护病房（ICU）进行了一项多中心回顾性队列研究，以评估COVID-19患者hs-cTnT水平对院内死亡率的预测能力。
结果
纳入了111例实验室确诊的COVID-19患者（68%为男性，中位年龄67（58 - 75）岁）。在入住ICU时，Charlson指数、简化急性生理学评分II和PaO/FiO的中位数分别为3（2 - 5）、37（27 - 48）和140（98 - 154），hs-cTnT血清水平的中位数为16.0（10.1 - 31.9）ng/L。75例患者（68%）接受了机械通气，41例（37%）接受了去甲肾上腺素治疗，17例（15%）接受了肾脏替代治疗。院内死亡率为29%（32/111），且与较低的PaO/FiO和较高的hs-cTnT血清水平独立相关。
结论
在入住ICU时，除了PaO/FiO外，hs-cTnT水平可能有助于对重症COVID-19患者进行早期风险分层和分诊。
Zotero 插件