ABSTRACT
Background:
Acute cardiac
injury (ACI) after COVID-19 has been linked with unfavorable clinical outcomes, but data on the clinical impact of elevated cardiac
troponin on discharge during follow-up are scarce. Our objective is to elucidate the clinical outcome of
patients with elevated
troponin on discharge after surviving a COVID-19
hospitalization.
Methods:
We conducted an
analysis in the prospective
registry HOPE-2 (NCT04778020). Only
patients discharged alive were selected for
analysis, and all-cause
death on follow-up was considered as the primary endpoint. As a
secondary endpoint, we established any long-term COVID-19 symptoms.
HOPE-2 stopped enrolling
patients on 31 December 2021, with 9299
patients hospitalized with COVID-19, of which 1805 were deceased during the acute phase. Finally, 2382
patients alive on discharge underwent
propensity score matching by relevant baseline variables in a 13 fashion, from 56 centers in 8 countries.
Results:
Patients with elevated
troponin experienced significantly higher all-cause
death during follow-up (log-rank = 27.23, p < 0.001), and had a higher chance of experiencing long-term COVID-19 cardiovascular symptoms. Specifically,
fatigue and
dyspnea (57.7% and 62.8%, with p-values of 0.009 and <0.001, respectively) are among the most common.
Conclusions:
After surviving the acute phase,
patients with elevated
troponin on discharge present increased
mortality and long-term COVID-19 symptoms over
time, which is clinically relevant in follow-up visits.