Skip to main content Accessibility help
×
Home
Hostname: page-component-55597f9d44-l69ms Total loading time: 0.296 Render date: 2022-08-18T08:03:34.339Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true } hasContentIssue true

The role and efficacy of routine high-sensitivity troponin T screening in paediatric COVID-19

Published online by Cambridge University Press:  06 January 2022

Mehmet G. Ramoğlu
Affiliation:
Department of Pediatric Cardiology, Ankara University, School of Medicine, Ankara, Turkey
Selen Karagözlü
Affiliation:
Department of Pediatric Cardiology, Ankara University, School of Medicine, Ankara, Turkey
Özlem Bayram
Affiliation:
Department of Pediatric Cardiology, Ankara University, School of Medicine, Ankara, Turkey
Jeyhun Bakhtiyarzada
Affiliation:
Department of Pediatric Cardiology, Ankara University, School of Medicine, Ankara, Turkey
Alperen Aydın
Affiliation:
Department of Pediatric Cardiology, Ankara University, School of Medicine, Ankara, Turkey
Göksel Vatansever
Affiliation:
Department of Pediatric Emergency Medicine, Ankara University, School of Medicine, Ankara, Turkey
Halil Özdemir
Affiliation:
Department of Pediatric Infectious Diseases, Ankara University, School of Medicine, Ankara, Turkey
Deniz Tekin
Affiliation:
Department of Pediatric Emergency Medicine, Ankara University, School of Medicine, Ankara, Turkey
Tayfun Uçar
Affiliation:
Department of Pediatric Cardiology, Ankara University, School of Medicine, Ankara, Turkey
Ergin Çiftçi
Affiliation:
Department of Pediatric Infectious Diseases, Ankara University, School of Medicine, Ankara, Turkey
Ercan Tutar*
Affiliation:
Department of Pediatric Cardiology, Ankara University, School of Medicine, Ankara, Turkey
*
Author for correspondence: Prof Dr E. Tutar, Ankara Üniversitesi Tıp Fakültesi Hastanesi, Tıp Fakültesi Caddesi, Cebeci/Çankaya, Ankara 06590, Türkiye. Tel: +905323451201; Fax: +903123106371. E-mail: ercantutar@gmail.com

Abstract

Objective:

We aimed to evaluate the efficacy and role of high-sensitivity troponin T in children with a confirmed SARS-CoV-2 infection and also the correlation of troponin T levels with symptoms, and echocardiographic findings were analysed.

Methods:

Two hundred and fourteen patients with a confirmed SARS-CoV-2 infection between the dates of 28 March and 15 August 2020 were enrolled in this retrospective single-centre study. Patients with comorbidities and diagnosed as multisystem inflammatory syndrome in children were excluded. Demographic data, clinical and laboratory parameters were evaluated. The patients were classified and compared according to the troponin positivity. The correlation of troponin T with symptoms and echocardiographic findings was analysed.

Results:

The most common symptoms in the whole study group were fever (53.3%) and cough (24.8%). Troponin T levels were elevated in 15 (7%) patients. The most common symptom in patients with troponin positivity was also fever (73.3%). Troponin T positivity was significantly higher in patients under the age of 12 months and troponin T levels were negatively correlated with age. C-reactive protein levels were elevated in 77 (36%) of the patients in the whole group and 7 (46.7%) of 15 patients with troponin positivity. C-reactive protein levels were similar between groups.

Conclusion:

Routine troponin screening does not yield much information in previously healthy paediatric COVID-19 patients without any sign of myocardial dysfunction. Elevated troponin levels may be observed but it is mostly a sign of myocardial injury without detectable myocardial dysfunction in this group of patients.

Type
Original Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

The online version of this article has been updated since original publication. A notice detailing the change has also been published

References

Lai, CC, Wang, CY, Wang, YH, Hsueh, SC, Ko, WC, Hsueh, PR. Global epidemiology of coronavirus disease 2019 (COVID-19): disease incidence, daily cumulative index, mortality, and their association with country healthcare resources and economic status. Int J Antimicrob Agents 2020; 55: 105946.CrossRefGoogle ScholarPubMed
Park, SE. Epidemiology, virology, and clinical features of severe acute respiratory syndrome -coronavirus-2 (SARS-CoV-2; Coronavirus Disease-19). Clin Exp Pediatr 2020; 63: 119124.CrossRefGoogle Scholar
Huang, C, Wang, Y, Li, X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan. China Lancet 2020; 395: 497506.CrossRefGoogle ScholarPubMed
Henry, BM, Benoit, SW, de Oliveira, MHS, et al. Laboratory abnormalities in children with mild and severe coronavirus disease 2019 (COVID-19): a pooled analysis and review. Clin Biochem 2020; 81: 18.CrossRefGoogle ScholarPubMed
Cantarutti, N, Battista, V, Adorisio, R, et al. Cardiac manifestations in children with SARS-COV-2 infection: 1-year pediatric multicenter experience. Children (Basel) 2021; 8: 717.Google ScholarPubMed
Yamamoto, L, Santos, EHD, Pinto, LS, et al. SARS-CoV-2 infections with emphasis on pediatric patients: a narrative review. Rev Inst Med Trop Sao Paulo 2020; 62: e65.CrossRefGoogle ScholarPubMed
Lu, X, Zhang, L, Du, H, et al. SARS-CoV-2 infection in children. N Engl J Med 2020; 382: 16631665.CrossRefGoogle ScholarPubMed
Liguoro, I, Pilotto, C, Bonanni, M, et al. SARS-COV-2 infection in children and newborns: a systematic review. Eur J Pediatr 2020; 179: 10291046.CrossRefGoogle ScholarPubMed
Riphagen, S, Gomez, X, Gonzalez-Martinez, C, Wilkinson, N, Theocharis, P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet 2020; 395: 16071608.CrossRefGoogle ScholarPubMed
Ponsford, MJ, Burton, RJ, Smith, L, et al. Examining the utility of extended laboratory panel testing in the emergency department for risk stratification of patients with COVID-19: a single-center retrospective service evaluation. J Clin Pathol 2021. doi: 10.1136/jclinpath-2020-207157 (Online ahead of print)Google Scholar
Khan, M, Shah, N, Mushtaq, H, Jehanzeb, V. Profiling laboratory biomarkers associated with COVID-19 disease progression: a single-center experience. Int J Microbiol 2021; 2021: 6643333.CrossRefGoogle ScholarPubMed
Parsons, IT, Parsons, AT, Balme, E, et al. The use of routine blood tests to assist the diagnosis of COVID-19 in symptomatic hospitalized patients. Ann Clin Biochem 2021; 58: 318326.CrossRefGoogle Scholar
Imazio, M, Klingel, K, Kindermann, I, et al. COVID-19 pandemic and troponin: indirect myocardial injury, myocardial inflammation or myocarditis? Heart 2020; 106: 11271131.CrossRefGoogle ScholarPubMed
Demir, OM, Ryan, M, Cirillo, C, et al. Impact and determinants of high-sensitivity cardiac troponin-T concentration in patients with COVID-19 admitted to critical care. Am J Cardiol 2021; 147: 129136.CrossRefGoogle ScholarPubMed
WHO Coronavirus (COVID-19) Dashboard.Google Scholar
Gullu, UU, Gungor, S, Ipek, S, Yurttutan, S, Dilber, C. Predictive value of cardiac markers in the prognosis of COVID-19 in children. Am J Emerg Med 2021; 48: 307311.10.1016/j.ajem.2021.06.075CrossRefGoogle ScholarPubMed
Kim, CW, Aronow, WS. COVID-19, cardiovascular diseases and cardiac troponins. Future Cardiol 2021. doi: 10.2217/fca-2021-0054 (Online ahead of print)Google ScholarPubMed
Guo, T, Fan, Y, Chen, M, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol 2020; 5: 811818.CrossRefGoogle Scholar
Vakhshoori, M, Heidarpour, M, Shafie, D, Taheri, M, Rezaei, N, Sarrafzadegan, N. Acute cardiac injury in COVID-19: a systematic review and meta-analysis. Arch Iran Med 2020; 23: 801812.CrossRefGoogle ScholarPubMed
Moutchia, J, Pokharel, P, Kerri, A, et al. Clinical laboratory parameters associated with severe or critical novel coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis. PLoS One 2020; 15: e0239802.CrossRefGoogle ScholarPubMed
Stefanini, GG, Chiarito, M, Ferrante, G, et al. Early detection of elevated cardiac biomarkers to optimise risk stratification in patients with COVID-19. Heart 2020; 106: 15121518.CrossRefGoogle ScholarPubMed
Ben-Shimol, S, Livni, G, Megged, O, et al. COVID-19 in a subset of hospitalized children in Israel. J Pediatric Infect Dis Soc 2021; 10: 757765.CrossRefGoogle Scholar
Ni, Z, Guo, Z, Chen, X, et al. Cardiac injury in patients with pandemic 2009 influenza A (H1N1) infection. Acta Cardiol 2011; 66: 427432.CrossRefGoogle ScholarPubMed
Pizzini, A, Burkert, F, Theurl, I, Weiss, G, Bellmann-Weiler, R. Prognostic impact of high sensitive troponin T in patients with influenza virus infection: a retrospective analysis. Heart Lung 2020; 49: 105109.CrossRefGoogle ScholarPubMed
Myhre, PL, Prebensen, C, Jonassen, CM, Berdal, JE, Omland, T. SARS-CoV-2 viremia is associated with inflammatory, but not cardiovascular biomarkers, in patients hospitalized for COVID-19. J Am Heart Assoc 2021; 10: e019756.CrossRefGoogle Scholar
Jehlicka, P, Rajdl, D, Sladkova, E, Sykorova, A, Sykora, J. Dynamic changes of high-sensitivity troponin T concentration during infancy: clinical implications. Physiol Res 2021; 70: 2732.CrossRefGoogle ScholarPubMed
Clerico, A, Aimo, A, Cantinotti, M. High-sensitivity cardiac troponins in pediatric population. Clin Chem Lab Med 2022; 60: 1832.CrossRefGoogle ScholarPubMed
Lam, E, Higgins, V, Zhang, L, et al. Normative values of high-sensitivity cardiac troponin T and N-terminal pro-B-type natriuretic peptide in children and adolescents: a study from the CALIPER Cohort. J Appl Lab Med 2021; 6: 344353.CrossRefGoogle ScholarPubMed

Linked content

Please note a has been issued for this article.

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

The role and efficacy of routine high-sensitivity troponin T screening in paediatric COVID-19
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

The role and efficacy of routine high-sensitivity troponin T screening in paediatric COVID-19
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

The role and efficacy of routine high-sensitivity troponin T screening in paediatric COVID-19
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *