Vol. 6, Issue 2, Part C (2024)

Background: A considerable proportion of COVID-19 patients may develop cardiac injury (characterized by elevated cardiac Troponin-I) which potentiate an increased risk of in-hospital morbidity & mortality. However, there is a lack of data in our country regarding the role of Troponin-I and its relation with outcome of the COVID-19 patients. Therefore, this study aimed to assess the association between level of serum Troponin-I and in-hospital outcome of COVID-19 patients.
Methods: This cohort study was conducted in the department of cardiology, Dhaka medical college hospital (DMCH) for 12 months’ period. Following informed written consent, detailed history, physical examination and necessary investigations were performed. Total 100 adult admitted RT-PCR positive COVID -19 patients were included in this study. Troponin-I >0.1 ng/ml in the first 24 h of admission was taken as Group A (exposed group), and ≤ 0.1 ng/ml was taken as Group B (unexposed group). All patients were assessed up to discharge or death. Data were collected by using a semi-structured questionnaire. Collected data were analyzed by the SPSS 23.
Results: Mean age of all patient was 55.63±8.06 years (range: 42-72 years) with maximum belonged to ≤60 years of age (71%) and male gender (53%). The most common risk factors was smoking (40%), diabetes mellitus (37%) followed in decreasing order dyslipidemia (31%), hypertension (30%), mean Troponin-I was 3.26±2.01 NG/ml, maximum (60%) of the study patients had normal Troponin-I level, while rest 40% had elevated Troponin-I level. Maximum (60%) study patients Group B (unexposed group) developed less complication in terms of acute heart failure (5%), cardiogenic shock (3.33%), malignant arrythmia (1.6%), while in Group A (exposed group) developed more complications in terms of acute heart failure (30%), malignant arrhythmia (27.5%), cardiogenic shock (20%) and ARDS (7.5%). besides, patients with high Troponin-I level Group A (exposed group) significantly needed more ICU support (52.5% VS 1.67%, p<0.001), longer hospital stay (14.38±2.02 VS 12.85±1.75 days, p<0.001) and higher mortality rate (50% vs 1.67%, p<0.001) compared to patients with normal troponin-I level Group B (unexposed group). 
Conclusion: Measuring cardiac Troponin-I levels on presentation could help predict the outcome in COVID-19 patients. However, further studies are needed to establish and use the findings.