TY  - BOOK
AU  - Ben-Dor, Itsik
AU  - Case, Brian
AU  - Chezar-Azerrad, Chava
AU  - Forrestal, Brian
AU  - Hashim, Hayder
AU  - Medranda, Giorgio
AU  - Rappaport, Hank
AU  - Rogers, Toby
AU  - Satler, Lowell F
AU  - Shea, Corey
AU  - Waksman, Ron
AU  - Weintraub, William S
AU  - Yerasi, Charan
AU  - Zhang, Cheng
TI  - The Impact of COVID-19 Patients With Troponin Elevation on Renal Impairment and Clinical Outcome
SN  - 1878-0938
PY  - 2021///
KW  - *COVID-19
KW  - Aged
KW  - Hospital Mortality
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Pandemics
KW  - Retrospective Studies
KW  - SARS-CoV-2
KW  - Troponin
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Advanced Cardiac Catheterization Research Fellowship
KW  - Interventional Cardiology Fellowship
KW  - Journal Article
N1  - Available in print through MWHC library: 2002 - present
N2  - BACKGROUND: Cardiac involvement in coronavirus disease 2019 (COVID-19) is known, manifested by troponin elevation, and these patients have a worse prognosis than patients without myocardial injury; CONCLUSION: COVID-19 patients with troponin elevation are at higher risk for worsening renal function, and these patients subsequently have worse in-hospital clinical outcomes. Efforts should focus on early recognition, evaluation, and intensifying care of these patients. Copyright (c) 2021. Published by Elsevier Inc; METHODS: We analyzed COVID-19-positive patients who presented to the MedStar Health system (11 hospitals in Washington, DC, and Maryland) during the pandemic (March 1-September 30, 2020). We compared renal function and subsequent in-hospital clinical outcomes based on the presence or absence of troponin elevation. The primary outcome was the incidence of acute kidney injury in COVID-19 patients with troponin elevation. We also evaluated in-hospital mortality, overall and based on the presence and absence of both troponin elevation and renal dysfunction; RESULTS: The cohort included 3386 COVID-19-positive admitted patients for whom troponin was drawn. Of these patients, 195 had troponin elevation (defined as >=1.0 ng/mL), mean age was 61 +/- 16 years, and 51% were men. In-hospital mortality was significantly higher (53.8%) in COVID-19-positive patients with concomitant troponin elevation than in those without troponin elevation (14.5%; p < 0.001). COVID-19-positive patients with troponin elevation had a higher prevalence of renal dysfunction (58.5%) than those without troponin elevation (23.4%; p < 0.001). Further analysis demonstrated that having both troponin elevation and renal dysfunction carried the worst in-hospital prognosis (in-hospital mortality 57.9%; intensive-care-unit admission 76.8%; ventilation requirement 63.2%), as compared to the absence or presence of either
UR  - https://dx.doi.org/10.1016/j.carrev.2021.05.004
ER  -