High-Sensitive Cardiac Troponin I - An Important Biomarker in the Course of COVID-19 Disease in Adult Patients

Introduction: SARS-CoV-2 virus, in addition to causing pneumonia, can cause direct damage to the heart, inducing myocarditis, pericarditis or AMI with significant impairment of cardiac contractility. Adult patients with hypertension, diabetes mellitus and obesity are at increased cardiovascular risk and complications from COVID-19.

Aim: To assess high-sensitivity troponin I (hs-TnI) levels among hospitalized patients with COVID-19 as a biomarker associated with myocardial damage and determine the correlation with disease severity and outcome.

Material and Method: A retrospective analysis of hospitalized patients was performed between January 1 and May 1, 2021, with clinical and laboratory evidence of COVID-19. Monitored were the laboratory parameters of myocardial damage with baseline and peak hs-TnI values above the median (≥19.8 ng/L) in 110 patients. The extent of the inflammatory response (СRP), coagulation status (DDimer), acid-base balance parameters, hypoxemia abnormalities and LDH levels according to disease severity and outcome, and length of hospital stay was assessed. Data were evaluated using descriptive, correlation and multivariate analysis.

Results: The present study showed a statistically significant relationship between disease severity and heart damage. The hs-TnI values in patients with COVID-19 and CVD were statistically significantly higher than those with COVID-19 but without CVD. The most significant levels of the cardiac biomarker are observed in deceased patients.

Conclusion: High-sensitive troponin is a valuable biomarker for early diagnosis and assessment of disease progression with a worse prognosis in patients with COVID-19. Elevated hs-TnI in patients with SARS-CoV-2 infection who have concomitant heart disease may suggest the severity of the clinical picture and the course of the disease.