Increasing cardiac troponin-I level as a cardiac injury index correlates with in-hospital mortality and biofactors in severe hospitalised COVID-19 patients

Background: Severe acute respiratory syndrome coronavirus-2 raised in 2019 (COVID-19) affects the lung tissue and other organs, specifically the heart.Methods: The current study evaluated 120 hospitalised patients with severe COVID-19 between March 2021 and February 2022. Patients' demographics, vital signs, electrocardiogram abnormalities, clinical laboratory tests, including troponin I (TPI), mortality, and discharge type, were recorded.Results: Among the 120 hospitalised patients with severe COVID-19, 54 (45.0%) patients were male, with an average age of 63.2 +/- 1.4. Many patients have chronic comorbidities, including hypertension (51.6%), diabetes mellitus (34.1%), and ischemic heart disease (17.5%). The in-hospital and six months after the discharge mor-tality were 45.8% and 21.5%, respectively. Cardiac injury was observed in 14 (11.7%) patients with a mean TPI level of 8.386 +/- 17.89 mu g/L, and patients with cardiac injury had higher mortality than those without cardiac injury (P < 0.001). Furthermore, the cardiac injury was meaningfully correlated with age (p = 0.182, P = 0.019), history of ischemic heart disease (p = 0.176, P = 0.05), hospitalisation result and mortality (p = 0.261, P = 0.004), inpatient in ICU (p = 0.219, P = 0.016), and serum levels of urea (p = 0.244, P = 0.008) and creatinine (p = 0.197, P = 0.033). Additionally, the discharge results were significantly correlated with oxygen saturation with (p =-0.23, P = 0.02) and without (p =-0.3, P = 0.001) oxygen therapy, D-dimer (p = 0.328, P = 0.019), LDH (p = 0.308, P = 0.003), urea (p = 0.2, P = 0.03), and creatinine (p = 0.17, P = 0.06) levels.Conclusion: Elevated TPI levels are associated with increased mortality in severe COVID-19 patients. Therefore, TPI may be a beneficial biofactor for early diagnosis of cardiac injury and preventing a high mortality rate.

Automated summary

This study evaluated 120 hospitalized patients with severe COVID-19 and found that cardiac injury is associated with increased mortality. It suggests that early diagnosis of cardiac injury and prevention of high mortality can be achieved through the detection of troponin I (TPI).