Measuring High-sensitive Cardiac Troponin Concentrations Predicted Hospital Deaths in Children With Severe Coronavirus Disease 2019

BACKGROUND: Antiviral drugs and coronavirus disease 2019 (COVID-19) vaccines have significantly reduced COVID-19-related hospitalizations and deaths in infected children. However, COVID-19 continues to pose a major mortality risk in young children. High-sensitive cardiac troponin (Hs-cTn) is a specific marker of myocardial cell damage. After infection with the novel coronavirus, myocardial cells are damaged, and high-sensitive troponin will increase. In this study, we aimed to evaluate the predictive power of hs-cTnT for in-hospital mortality in pediatric COVID-19 patients. METHODS: In this study, which was conducted between December 2021 and January 2022, we included severely ill pediatric COVID-19 patients. We recorded their clinical data. Then, the association of hs-cTnT levels with mortality and of alanine aminotransferase and creatinine levels with mortality was analyzed. RESULTS: For the 119 children (70 males and 49 females) with severe COVID-19 included, the findings of univariate and multivariable Cox regression analyses revealed a significant association between hs-cTnT and in-hospital mortality (hazard ratio: 14.835; 95% confidence interval: 6.051-36.373; P < 0.001). The cutoff level of hs-cTnT to accurately predict in-hospital mortality was 0.09 ng/mL (area under the curve: 0.989; sensitivity: 1.000; specificity: 0.961; Youden index: 0.961). CONCLUSION: In severely ill children with COVID-19 infection, hs-cTnT can be used as an independent biomarker to predict in-hospital mortality. The optimum cutoff was 0.09 ng/mL.