Published online Aug 28, 2021. doi: 10.13105/wjma.v9.i4.342
Peer-review started: March 28, 2021
First decision: April 28, 2021
Revised: July 3, 2021
Accepted: August 24, 2021
Article in press: August 24, 2021
Published online: August 28, 2021
The increase in circulating Troponin-I in the blood of patients suffering coronavirus disease 2019 (COVID-19) can be a strong prognostic factor for predicting disease poorer outcome.
To review the literatures to approve this claim systematically.
Two blinded reviewers independently screened the titles and abstracts of the manuscripts using the keywords and deeply searching the databanks including PubMed, Scopus, Google Scholar, and Web of knowledge, followed by profo
The manuscripts entered into our final assessment were categorized as the two groups including 10 manuscripts describing and comparing death and disease-related complications between the subgroups of patients with raised serum troponin level and those with normal ranges of this biomarker and 7 manuscripts comparing the mean level of serum troponin concentration across the survived and non-survived groups. Comparing outcome of COVID-19 disease in the groups with raised troponin level and normal level of this markers showed increased the likelihood of death [hazard ratio (HR) = 4.967, P < 0.001], acute respiratory distress syndrome (HR = 5.914, P < 0.001), acute kidney injury (HR = 3.849, P < 0.001), and intensive care unit (ICU) admission (HR = 3.780, P < 0.001) following raise of troponin. The pooled analysis showed significantly higher concentration of this marker in the survived group compared to non-survived group (weighted mean differences of 22.278, 95%CI: 15.647 to 28.927, P < 0.001).
Raising troponin-I on admission can be linked to the increase risk for in-hospital death, acute respiratory distress syndrome, kidney injury, and ICU admission by 4.9, 5.9, 3.8, and 3.7 times as compared to those with initial normal troponin-I concentration. Thus, raising baseline value of troponin-I can be used as a prognostic factor for poor outcome of COVID-19.
Core Tip: We systematically reviewed the literatures to assess this claim that an increase in troponin-I levels could be a prognostic factor in predicting disease severity and mortality in patients with coronavirus disease 2019. According to our findings, regardless of the history of myocardial injuries or the presence of cardiovascular risk profile, the value of troponin I should be accurately assessed on admission. Raising troponin-I on admission can be linked to the increase risk for in-hospital death, acute respiratory distress syndrome, kidney injury, and intensive care unit admission by 4.9, 5.9, 3.8, and 3.7 times as compared to those with initial normal troponin I concentration.