Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Aug 28, 2021; 9(4): 342-352
Published online Aug 28, 2021. doi: 10.13105/wjma.v9.i4.342
Troponin I biomarker as a strong prognostic factor for predicting COVID-19 mortality: A systematic review
Haleh Ashraf, Abbas Soleimani, Ali Kazemi saeid, Azadeh Sadat Naseri, Fazeleh Majidi, Niloufar Peirovi, Shahrokh Karbalai Saleh
Haleh Ashraf, Abbas Soleimani, Ali Kazemi saeid, Azadeh Sadat Naseri, Shahrokh Karbalai Saleh, Department of Cardiology, Tehran University of Medical Sciences, Tehran 1136746911, Iran
Haleh Ashraf, Cardiac Primary Prevention Research Center (CPPRC), Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, zip code 1411713138
Fazeleh Majidi, Niloufar Peirovi, Reserch and Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran 1136746911, Iran
Author contributions: Ashraf H, Soleimani A, Kazemi saeid A, Sadat Naseri A, Majidi F, Peirovi N, Karbalai Saleh S have contributed equally and provided critical feedback and helped shape the research, analysis, and manuscript.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shahrokh Karbalai Saleh, MD, Assistant Professor, Department of Cardiology, Tehran University of Medical Sciences, Imam Khomeini St. Sina Hospital, Tehran 1136746911, Iran. saleh6948@yahoo.com
Received: March 28, 2021
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
ARTICLE HIGHLIGHTS
Research background

Troponin-I on admission has a high predicting value for coronavirus disease 2019 (COVID-19) related mortality. Troponin-I on admission has a high predicting value for COVID-19 related morbidity. Troponin-I can strongly predict disease sequels including acute respiratory distress syndrome (ARDS), kidney injury, and Intensive care units (ICU) admission requirement.

Research motivation

Accurate and early diagnosis and determination of COVID-19 severity can prevent its further progression. The increase in circulating troponin-I in the blood of patients suffering COVID-19 can be a strong prognostic factor for predicting disease poorer outcome. We systematically reviewed the literatures to approve this claim.

Research objectives

The increase in circulating troponin-I in the blood of patients suffering COVID-19 can be a strong prognostic factor for predicting disease poorer outcome.

Research methods

Deeply searching the manuscript databanks was planned. All studies that evaluated the link between the serum level of troponin-I and two COVID-19 related parameters including disease severity and mortality were considered to be eligible for primary assessment. The review papers, case presentations, letter to editors, non-English studies, and abstracts without full text access were all excluded. The manuscript reviewing was done by two blinded reviewers, screening the titles and abstracts followed by profound appraisement of the full texts independently to assess the inclusion appropriateness. The presence of any disagreement between them was judged and checked again by another reviewer as the last arbiter.

Research results

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 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).

Research conclusions

In conclusion, 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 because of its high predicting value for COVID-19 related mortality and morbidity.

Research perspectives

The value of troponin-I should be accurately assessed on admission because of its high predicting value for COVID-19 related mortality and morbidity.