Impact of High Troponin Level on the Outcome in COVID-19 Positive Patients

Abstract

Samah I Abohamr,1,2 Mohammad O Kattea,3 Rami M Abazid,4 Mubarak A Aldossari,2 Nayef Al Asiri,2 Ayman Uthman Alhussini,2 Khalid I Al Hussaini,5 Glowi A Alasiri,6 Asghar Ali,7 Eman Elsheikh1,8 1Department of Cardiology, College of Medicine, Tanta University Hospital, Tanta, Egypt; 2Chairman of cardiology services, Mouwasat medical group, Al-Khobar, Saudi Arabia; 3Nassau University Medical Center, East Meadow, NY, USA; 4Internal Medicine Department, Sault Area Hospital, Sault Ste Marie, Northern Ontario Medical School University (NOSM), Sault Ste Marie, Ontario, Canada; 5Department of Internal Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, 4233-13317, Saudi Arabia; 6Department of Biochemistry, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, 4233-13317, Saudi Arabia; 7Clinical Biochemistry Laboratory, Department of Biochemistry, School of Chemical and Life Sciences (SCLS), Jamia Hamdard, New Delhi, 110062, India; 8Internal Medicine Department, King Faisal University, Alahsa, Saudi ArabiaCorrespondence: Khalid I Al Hussaini, Department of Internal Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, 4233-13317, Saudi Arabia, Email [email protected] Asghar Ali, Clinical Biochemistry Laboratory, Department of Biochemistry, School of Chemical and Life Sciences (SCLS), Jamia Hamdard, New Delhi, 110062, India, Email [email protected]: COVID-19 is a new disease caused by the recently discovered SARS-CoV-2 virus. The COVID-19 disease manifests in several ways and it may affect various systems, including the gastrointestinal, musculoskeletal, neurological, cardiovascular, and pulmonary systems. Individuals who have ad-additional health conditions, such as cardiovascular disorders, are particularly more likely to experience illness and death. This study aimed to assess the clinical effect of COVID-19 on myocardial injury, as measured by troponin elevation, and to determine if this effect has an impact on the outcome.Patients and Methods: This retrospective study was conducted at King Saud Medical City. The electronic medical records used to identify all admitted patients between March 23 and June 15, 2020, with a laboratory-confirmed positive COVID-19 diagnosis who had troponin I measured.Results: During the study period, 768 COVID-19-positive patients were hospitalized. Of those, 187 patients were excluded because the troponin level was not measured. The remaining 581 (75.7%) had troponin I measured. Overall, 89 of 581 (15.3%) patients died. Of those, 67.8% were in the markedly elevated cTnI group, 8.5% were in the mildly elevated cTnI group, whereas no deaths were reported in the group with normal cTnI levels.Conclusion: Myocardial injury was observed in COVID-19-admitted patients at a significant level that warrants attention to this consequence. In older individuals with pre-existing cardiovascular comorbidities, the diagnosis of myocardial injury was linked to a higher likelihood of being admitted to the intensive care unit, experiencing a worse prognosis, and ultimately, death.Keywords: myocardial infarction, cardiovascular comorbidities, ARDS, biomarker, cytokine storm, risk stratification

Keywords

• myocardial infarction
• cardiovascular comorbidities
• ards
• biomarker
• cytokine storm
• risk stratification.