Cardiac Troponin Testing in Patients with COVID-19: A Strategy for Testing and Reporting Results

Clin Chem. 2021 Jan 8;67(1):107-113. doi: 10.1093/clinchem/hvaa225.

Abstract

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged late in 2019 causing COVID-19 (coronavirus disease-2019) may adversely affect the cardiovascular system. Publications from Asia, Europe, and North America have identified cardiac troponin as an important prognostic indicator for patients hospitalized with COVID-19. We recognized from publications within the first 6 months of the pandemic that there has been much uncertainty on the reporting, interpretation, and pathophysiology of an increased cardiac troponin concentration in this setting.

Content: The purpose of this mini-review is: a) to review the pathophysiology of SARS-CoV-2 and the cardiovascular system, b) to overview the strengths and weaknesses of selected studies evaluating cardiac troponin in patients with COVID-19, and c) to recommend testing strategies in the acute period, in the convalescence period and in long-term care for patients who have become ill with COVID-19.

Summary: This review provides important educational information and identifies gaps in understanding the role of cardiac troponin and COVID-19. Future, properly designed studies will hopefully provide the much-needed evidence on the path forward in testing cardiac troponin in patients with COVID-19.

Keywords: COVID-19; acute care; cardiac troponin; risk stratification.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Biomarkers / blood
  • COVID-19 / blood*
  • COVID-19 / complications
  • COVID-19 / epidemiology
  • COVID-19 / virology
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / diagnosis
  • Humans
  • Pandemics
  • SARS-CoV-2 / isolation & purification
  • Sensitivity and Specificity
  • Troponin / blood*

Substances

  • Biomarkers
  • Troponin