New study: Heart injury test may help COVID-19 patients avoid hospitalisation
A new study led by MD student and cardiologist Dr Alexander Liu may have significant implications for COVID-19 risk stratification. This practice involves identifying populations who are more or less at risk of COVID-19-related mortality. This in turn allows clinicians to determine which people may need closer monitoring or, alternatively, can be safely discharged from hospital.
Supervised by Dr Robert Hammond, Professor Peter Donnelly and Professor Anthony Coates, Dr Liu examined whether a common test for heart injury could be used to predict individual mortality risk in COVID-19 patients. Elevated levels of cardiac troponins, a protein released into the blood following heart damage, have consistently been associated with increased risk of death in this population. Based on this population-level trend, Dr Liu hypothesised that troponin levels would also successfully predict whether an individual COVID-19 patient would suffer mortality. If accurate, he proposed, this simple, rapid test could potentially serve as a key risk stratification tool for physicians treating the virus.
Dr Liu ultimately found that cardiac troponin levels were not an accurate predictor of or “rule-in test” for individual mortality. The study did suggest, however, a potential role for the test in “ruling out” mortality, as patients with normal cardiac troponin levels had very good prognoses. This may be because normal troponin levels help to also rule out other conditions and complications that could put patients at a high risk of death.
“This study may be one small step towards clinical translation but potentially a giant leap for identifying the direction in which we need to go with COVID-19 risk-stratification. It now sets the stage for a future prospective validation of the rule-out powers of normal troponins. This could further propel the test into the Covid-19 clinical arena,” said Dr Liu.
“The ultimate vision is to open up the possibility of using cardiac troponins to help doctors send patients home safely, to reduce their risk of hospital exposure, potentially saving lives and millions for healthcare systems.”