{"doi":"10.1093/clinchem/hvab062","title":"High-Sensitivity Cardiac Troponin T for the Detection of Myocardial Injury and Risk Stratification in COVID-19","abstract":"BACKGROUND: Limited data exist on high-sensitivity cardiac troponin (hs-cTn) for risk-stratification in COVID-19. METHODS: We conducted a multicenter, retrospective, observational, US-based study of COVID-19 patients undergoing hs-cTnT. Outcomes included short-term mortality (in-hospital and 30-days post-discharge) and a composite of major adverse events, including respiratory failure requiring mechanical ventilation, cardiac arrest, and shock within the index presentation and/or mortality during the index hospitalization or within 30-days post-discharge. RESULTS: Among 367 COVID-19 patients undergoing hs-cTnT, myocardial injury was identified in 46%. They had a higher risk for mortality (20% vs 12%, P < 0.0001; unadjusted HR 4.44, 95% CI 2.13-9.25, P < 0.001) and major adverse events (35% vs. 11%, P < 0.0001; unadjusted OR 4.29, 95% CI 2.50-7.40, P < 0.0001). Myocardial injury was associated with major adverse events (adjusted OR 3.84, 95% CI 2.00-7.36, P < 0.0001) but not mortality. Baseline (adjusted OR 1.003, 95% CI 1.00-1.007, P = 0.047) and maximum (adjusted OR 1.005, 95% CI 1.001-1.009, P = 0.0012) hs-cTnT were independent predictors of major adverse events. Most (95%) increases were due to myocardial injury, with 5% (n = 8) classified as type 1 or 2 myocardial infarction. A single hs-cTnT <6 ng/L identified 26% of patients without mortality, with a 94.9% (95% CI 87.5-98.6) negative predictive value and 93.1% sensitivity (95% CI 83.3-98.1) for major adverse events in those presenting to the ED. CONCLUSIONS: Myocardial injury is frequent and prognostic in COVID-19. While most hs-cTnT increases are modest and due to myocardial injury, they have important prognostic implications. A single hs-cTnT <6 ng/L at presentation may facilitate the identification of patients with a favorable prognosis.","journal":"Clinical Chemistry","year":2021,"id":156703,"datarank":0.5983476069846413,"base_score":3.9889840465642745,"endowment":3.9889840465642745,"self_citation_contribution":0.5983476069846413,"citation_network_contribution":0.0,"self_endowment_contribution":0.5983476069846413,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":53,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9537,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":653218,"name":"Olatunde Ola","orcid":"0000-0001-5230-7037","position":1,"is_corresponding":false},{"id":653223,"name":"Jonathan D Knott","orcid":"0000-0002-2331-1165","position":2,"is_corresponding":false},{"id":653219,"name":"Ashok Akula","orcid":"0000-0002-1840-0999","position":3,"is_corresponding":false},{"id":377106,"name":"Ramila A. Mehta","orcid":"0000-0003-3769-3173","position":4,"is_corresponding":false},{"id":287453,"name":"David O. Hodge","orcid":null,"position":5,"is_corresponding":false},{"id":653221,"name":"Marshall Dworak","orcid":"0000-0001-6847-2416","position":6,"is_corresponding":false},{"id":232182,"name":"Eric H. Yang","orcid":"0000-0003-4889-7454","position":7,"is_corresponding":false},{"id":662701,"name":"Michael Gharacholou","orcid":null,"position":8,"is_corresponding":false},{"id":661979,"name":"Gurpreet Singh","orcid":"0000-0002-6722-4661","position":9,"is_corresponding":false},{"id":662702,"name":"Ripudamanjit Singh","orcid":null,"position":10,"is_corresponding":false},{"id":355743,"name":"Rajiv Gulati","orcid":"0000-0002-2713-0433","position":11,"is_corresponding":false},{"id":302756,"name":"Allan S. Jaffe","orcid":"0000-0003-1183-3959","position":12,"is_corresponding":false},{"id":653226,"name":"Yader Sandoval","orcid":"0000-0003-4800-2972","position":13,"is_corresponding":false},{"id":653220,"name":"Laura De Michieli","orcid":"0000-0003-0574-4052","position":0,"is_corresponding":true}],"reference_count":26,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T23:44:13.017332Z","pmid":"33860295","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}