Assessment of Troponin Levels as a Biomarker of Myocardial Injury in Patients with Fatal Covid-19 for the Period 2020 to 2022: A Literature Review

Abstract

Background: COVID-19 initially described at the end of 2019. COVID-19 is caused by an uncommon ‎coronavirus infection. Since then, it has been spreading rapidly and has caused a global pandemic, infecting more than 29 million people and causing more than ‎‎900,000 deaths as of September 15, 2020. In most cases this disease mainly affects the respiratory ‎system and can cause a syndrome called acute respiratory distress, leading to acute ‎respiratory failure. However, COVID-19 causes other systemic ‎indications, such as myocardial injury, coagulopathy, and cytokine storm. Myocardial injury patients were determined by elevated troponin levels by large number of COVID-19 patients, ranging from ''7.2% to 36%''. COVID-19 patients may experience myocardial injury due to other complications such as ‎arrhythmias, heart failure, or even sudden cardiac arrest, as well, COVID-19 is a complex disease that can cause severe respiratory ‎failure. Understanding these complications is crucial for ‎managing the disease ‎and developing effective treatment. Aim: This review research aims to assess the roles of troponin in COVID-19 patients at a higher risk of ‎myocardial injury, as well as shed light on the most significant research articles conducted in this ‎field of regard area between 2020 and 2022. Methods and Materials: This review outlined the latest scientific research for the period from 2020 to ‎‎2022 ‎associated with the involvement of cardiac injury in the population of COVID-19 ‎‎patients by focusing on the use of troponin levels as a vital ‎indication. Additionally, it is starting from ‎encountered patients with COVID-19, as well as it‎‏ is ‏‎related to the increased risk of ‎death data and it had a crucial role in the identification of COVID-19 with a high risk of hypoxia in the blood. At that point, it was going through the evidence regarding COVID-19 and ‎cardiovascular biomarkers, such as troponin articles recognized using the electronic ‎search, as performed via PubMed, Embase, and Google Scholar Database through a ‎comprehensive search conducted by combining key terms for instance; “biomarkers”, ’’myocarditis”, “COVID-19”, “troponin”. English-language articles were screened for ‎relevance and a full review of publications for the important studies was conducted, ‎including additional publications identified from individual article ‎reference lists. Conclusion: Cardiac troponin (cTn) is the most reliable test for detecting heart disease, particularly myocardial injury. Elevated levels of troponin (both cTnI and cTnT) are a critical risk factor for severe myocardial injury and hospitalizations, especially for COVID-19 patients who face a higher risk of adverse events. Therefore, measuring cTn levels is critical to monitor the progression of heart disease and effectively manage patients'

Keywords

• COVID-19
• Troponin levels
• IL-6
• cardiac troponin
• Myocardial injury