Elevated Troponins after COVID-19 Hospitalization and Long-Term COVID-19 Symptoms: Incidence, Prognosis, and Clinical Outcomes—Results from a Multi-Center International Prospective Registry (HOPE-2)
Abstract
:1. Introduction
2. Material and Methods
2.1. Study Design and Participation Criteria
2.2. Data Acquisition and Study Definitions
2.3. Study Follow-Up and Outcomes
2.4. Statistical Analysis
3. Results
4. Discussion
5. Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Matched Population (n = 312) | Elevated Troponin on Discharge (n = 78) | Not Elevated Troponin on Discharge (n = 234) | p-Value | ||
---|---|---|---|---|---|
Age (years) | 65.76 ± 14.90 | 65.69 ± 14.49 | 65.78 ± 14.73 | 0.966 | |
Male | 188 (60.3%) | 46 (59%) | 142 (60.7%) | 0.789 | |
Hypertension | 196 (62.8%) | 50 (64.1%) | 146 (62.4%) | 0.787 | |
Obesity | 60 (19.2%) | 14 (17.9%) | 46 (19.7%) | 0.740 | |
Diabetes Mellitus | 63 (20.2%) | 17 (21.8%) | 46 (19.7%) | 0.684 | |
Dislipidaemia | 107 (34.3%) | 27 (34.6%) | 80 (34.2%) | 0.945 | |
Active smoking | 42 (14%) | 19 (25.7%) | 23 (10.2%) | 0.001 | |
Renal failure | 21 (6.7%) | 8 (10.3%) | 13 (5.6%) | 0.151 | |
Lung disease | 68 (23.7%) | 14 (20.3%) | 54 (24.8%) | 0.446 | |
Heart disease | 130 (41.67%) | 32 (41%) | 98 (41.9%) | 0.895 | |
Cerebrovascular disease | 22 (7.1%) | 6 (7.7%) | 16 (6.8%) | 0.798 | |
Connectivopathy | 8 (2.6%) | 1 (1.3%) | 7 (3%) | 0.684 | |
Liver disease | 7 (2.2%) | 2 (2.6%) | 5 (2.1%) | 1.000 | |
Cancer status | 34 (10.9%) | 8 (10.3%) | 26 (11.1%) | 0.834 | |
Inmunosupression | 21 (6.7%) | 6 (7.7%) | 15 (6.4%) | 0.696 | |
In hospital complications | Respiratory insufficiency | 135 (43.5%) | 38 (48.7%) | 97 (41.5%) | 0.262 |
Heart failure | 29 (9.3%) | 16 (20.5%) | 13 (5.6%) | <0.001 | |
Renal failure | 41 (13.1%) | 15 (19.2%) | 26 (11.1%) | 0.066 | |
Upper respiratory tract infection | 39 (12.5%) | 11 (14.1%) | 28 (12%) | 0.621 | |
Pneumonia | 231 (76.2%) | 60 (76.9%) | 171 (76%) | 0.869 | |
Sepsis | 36 (11.5%) | 26 (33.3%) | 10 (4.3%) | <0.001 | |
Systemic inflammatory response syndrome | 36 (11.5%) | 7 (9%) | 29 (12.4%) | 0.413 | |
Relevant bleeding | 11 (3.5%) | 6 (7.7%) | 5 (2.1%) | 0.032 | |
Hemoptysis | 9 (2.9%) | 6 (7.7%) | 3 (1.3%) | 0.009 * | |
Embolic events | 6 (1.9%) | 3 (3.8%) | 3 (1.3%) | 0.168 | |
Hospital readmission for any cause | 81 (26%) | 37 (47.4%) | 44 (18.8%) | <0.001 | |
All-cause death | 19 (6.1%) | 14 (17.9%) | 5 (2.1%) | <0.001 | |
Follow-up | 12.97; 8.60–14.79 | 12.60; 7.07–13.23 | 13; 9.60–15.54 | - |
Matched Population (n = 312) | Elevated Troponin on Discharge (n = 78) | Not Elevated Troponin on Discharge (n = 234) | p-Value | ||
---|---|---|---|---|---|
Any long-term COVID-19 symptoms | 210 (67.3%) | 57 (73.1%) | 153 (65.4%) | 0.210 | |
Long-term COVID-19 cardiovascular traits | Fatigue | 140 (44.9%) | 45 (57.7%) | 95 (40.6%) | 0.009 |
Dyspnea | 123 (39.4%) | 49 (62.8%) | 74 (31.6%) | <0.001 | |
Dizziness | 48 (15.4%) | 23 (29.5%) | 25 (10.7%) | <0.001 | |
Chest pain | 36 (11.5%) | 15 (19.2%) | 21 (9%) | 0.014 | |
Acute coronary syndrome | 9 (2.9%) | 6 (7.7%) | 3 (1.3%) | 0.009 * | |
Palpitations | 47 (15.1%) | 23 (29.5%) | 24 (10.3%) | <0.001 | |
Increased resting heart rate | 13 (10.6%) | 14 (17.9%) | 19 (8.1%) | 0.015 | |
Syncope | 6 (1.9%) | 2 (2.6%) | 4 (1.7%) | 0.642 * | |
Arrhythmia | 41 (13.1%) | 20 (25.6%) | 21 (9%) | <0.001 | |
Atrial fibrillation | 32 (10.3%) | 10 (12.8%) | 22 (9.4%) | 0.389 | |
Peri/myocarditis | 5 (1.6%) | 5 (6.4%) | 0 (0%) | 0.001 * | |
Inferior limb edema | 24 (7.7%) | 12 (15.4%) | 12 (5.1%) | 0.003 | |
New onset hypertension | 13 (4.2%) | 3 (3.8%) | 10 (4.3%) | 1.000 | |
New onset ventricular dysfunction | 21 (6.7%) | 15 (19.2%) | 6 (2.6%) | <0.001 | |
Relevant bleeding | 2 (0.6%) | 1 (1.3%) | 1 (0.4%) | 0.438 * | |
Long-term COVID-19 neuro-psychological traits | Headache | 27 (8.7%) | 3 (3.8%) | 24 (10.3%) | 0.081 * |
Migraine | 13 (4.2%) | 1 (1.3%) | 12 (5.1%) | 0.197 * | |
Ageusia | 22 (7.1%) | 5 (6.4%) | 17 (7.3%) | 0.798 | |
Anosmia | 19 (6.1%) | 7 (9%) | 12 (5.1%) | 0.272 | |
Attention disorder | 26 (8.3%) | 9 (11.5%) | 7 (7.3%) | 0.237 | |
Memory loss | 11 (9.9%) | 10 (12.8%) | 21 (9%) | 0.325 | |
Cognitive impairment | 21 (6.7%) | 8 (10.3%) | 13 (5.6%) | 0.151 | |
Anxiety | 50 (16%) | 17 (21.8%) | 33 (14.1%) | 0.109 | |
Depression | 33 (10.6%) | 13 (16.7%) | 20 (8.5%) | 0.043 | |
Tinnitus or hearing loss | 13 (4.2%) | 6 (7.7%) | 7 (3%) | 0.098 * | |
Sleep disorder | 46 (14.7%) | 10 (12.8%) | 36 (15.4%) | 0.580 | |
Mood disorder | 39 (12.5%) | 14 (17.9%) | 25 (10.7%) | 0.093 | |
Paraonia | 10 (3.2%) | 5 (6.4%) | 5 (2.1%) | 0.128 | |
Other long-term COVID-19 symptoms | Cough | 47 (15.1%) | 21 (26.9%) | 26 (11.1%) | 0.001 |
Reduced pulmonary diffusion test | 31 (9.9%) | 13 (16.7%) | 18 (7.7%) | 0.022 | |
Polypnea | 18 (5.8%) | 8 (10.3%) | 10 (4.3%) | 0.087 | |
Sleep apnea | 15 (4.8%) | 5 (6.4%) | 10 (4.3%) | 0.540 | |
Digestive disorders | 22 (7.1%) | 10 (12.8%) | 12 (5.1%) | 0.022 | |
Nausea/Vomiting | 13 (4.2%) | 5 (6.4%) | 8 (3.4%) | 0.323 | |
Intermittent fever | 17 (5.4%) | 8 (10.3%) | 9 (3.8%) | 0.042 | |
Chills | 17 (5.4%) | 9 (11.5%) | 8 (3.4%) | 0.017 | |
Hair loss | 20 (6.4%) | 5 (6.4%) | 15 (6.4%) | 1.000 | |
Joint pain | 34 (10.9%) | 7 (9%) | 27 (11.5%) | 0.529 | |
Myalgias | 34 (10.9%) | 5 (6.4%) | 29 (12.4%) | 0.142 | |
Significant sweating episodes | 8 (2.6%) | 1 (1.3%) | 7 (3%) | 0.684 * | |
Significant weight loss | 24 (7.7%) | 3 (3.8%) | 21 (9%) | 0.141 * | |
Cutaneous involvement | 14 (4.5%) | 3 (3.8%) | 11 (4.7%) | 1.000 * | |
New onset diabetes mellitus | 7 (2.2%) | 2 (2.6%) | 5 (2.1%) | 1.000 * | |
New onset renal failure | 22 (7.1%) | 13 (16.7%) | 9 (3.8%) | <0.001 | |
Red eye symptoms | 4 (1.3%) | 0 (0%) | 4 (1.7%) | 0.575 * | |
Flushing | 1 (0.3%) | 0 (0%) | 1 (0.4%) | 1.000 * | |
Incident neoplasia | 6 (1.9%) | 3 (3.8%) | 3 (1.3%) | 0.168 |
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Vazirani, R.; Feltes, G.; Hoyo, R.S.-d.; Viana-Llamas, M.C.; Raposeiras-Roubín, S.; Romero, R.; Alfonso-Rodríguez, E.; Uribarri, A.; Santoro, F.; Becerra-Muñoz, V.; et al. Elevated Troponins after COVID-19 Hospitalization and Long-Term COVID-19 Symptoms: Incidence, Prognosis, and Clinical Outcomes—Results from a Multi-Center International Prospective Registry (HOPE-2). J. Clin. Med. 2024, 13, 2596. https://doi.org/10.3390/jcm13092596
Vazirani R, Feltes G, Hoyo RS-d, Viana-Llamas MC, Raposeiras-Roubín S, Romero R, Alfonso-Rodríguez E, Uribarri A, Santoro F, Becerra-Muñoz V, et al. Elevated Troponins after COVID-19 Hospitalization and Long-Term COVID-19 Symptoms: Incidence, Prognosis, and Clinical Outcomes—Results from a Multi-Center International Prospective Registry (HOPE-2). Journal of Clinical Medicine. 2024; 13(9):2596. https://doi.org/10.3390/jcm13092596
Chicago/Turabian StyleVazirani, Ravi, Gisela Feltes, Rafael Sánchez-del Hoyo, María C. Viana-Llamas, Sergio Raposeiras-Roubín, Rodolfo Romero, Emilio Alfonso-Rodríguez, Aitor Uribarri, Francesco Santoro, Víctor Becerra-Muñoz, and et al. 2024. "Elevated Troponins after COVID-19 Hospitalization and Long-Term COVID-19 Symptoms: Incidence, Prognosis, and Clinical Outcomes—Results from a Multi-Center International Prospective Registry (HOPE-2)" Journal of Clinical Medicine 13, no. 9: 2596. https://doi.org/10.3390/jcm13092596