Utility of cardiac bioenzymes in predicting cardiovascular outcomes in SARS-CoV-2

Table 1 Summary of studies characterizing the role of cardiac troponin

Study	Type of study	Location	Number of participants	Recommendation
Diagnostic and prognostic utility of troponin
Lala et al[14], 2020	Single center, Observational	New York	2736	cTn elevated in patients with primary cardiac etiology including MI. Other etiologies included arrythmias, HF, myocarditis and Takotsubu cardiomyopathy
Khaloo et al[15], 2022	Multicenter, Retrospective	Massachusetts	2450
Sandoval et al[17], 2020	Review			Serial cTn measurement aids in risk stratification
Almeida et al[18], 2020	Single center, Retrospective	Brazil	183	Elevated cTn measured within first 24 h is associated with worst prognosis. Increased need for MV
Maino et al[19], 2021	Single center, Retrospective	Italy	189
Arcari et al[20], 2020	Multicenter, Observational	Italy	111	cTn elevation correlated with poor prognosis and need for MV
Role in outcome and mortality
Scarl et al[21], 2021	Single center, Retrospective	Ohio	81	In patients with pre-existing comorbidities, CTnI elevation is associated with mortality
Lala et al[14], 2020	Single center, Observational	New York	2,736	Threefold increase in mortality in patients with cTnI three times the upper limit of normal
Mueller et al[22], 2021	Review			cTn elevation is associated with significant in hospital adverse events
Henein et al[23], 2021	Multicenter, Retrospective	International, mainly European	748
Kermali et al[24], 2020	Systematic review	China	607
Arcari et al[25], 2021	Multicenter, Retrospective	Italy	252	cTn significantly elevated in patients with pre-existing comorbidities, and is associated with increased mortality
Lombardi et al[26], 2020	Multicenter,Cross sectional	Italy	614	Elevation in cTn associated with mortality. 45.3% patients had elevated cTn and correlated with 71% increase in mortality, and a 2-fold increase in additional complications inlcuding sepsis, PE, AKI
Salvatici et al[27], 2020	Single center, Retrospective	Italy	523	cTnT and cTnI remain independent predictors of mortality even after adjusting for potential confounders
Al Abbasi et al[28], 2020	Single center, Retrospective	Florida	257	Elevated cTnI in the first 24 h of admission had a significantly higher in hospital mortality, with 89.7% negative predictive value

cTn: Cardiac troponin; cTnT: Troponin T; cTnI: Troponin I; HF: Heart failure; MV: Mechanical ventilation; PE: Pulmonary embolism; AKI: Acute kidney injury.