Troponin-I as a Prognostic Marker in Patients with Coronavirus Disease 2019: Insights from a Single-center Investigation

Abstract

Background: Troponin-I is conventionally correlated with myocardial injury, but its relevance in assessing the severity of coronavirus disease 2019 (COVID-19) and its implications for patient management remains an area of ongoing investigation. This study was designed to assess the correlation between troponin-I levels and the disease severity among patients with COVID-19. Materials and Methods: This retrospective study was conducted at a tertiary care center in India between April 2020 and November 2021. The patients with reverse transcription-polymerase chain reaction who tested positive for COVID-19 infection, and who underwent troponin-I examination at presentation were included in the study. A comparison of baseline clinical characteristics among patients who survived and who did not survive post-COVID-19 was done, and risk factors associated with mortality among hospitalized patients were analyzed. Results: A total of 1673 patients were enrolled in this study. Of these, 1431 patients survived, and 242 patients did not survive post-COVID-19. The mean age of the patients with troponin-I levels ≤0.06 ng/ml was 49.66 ± 17.88 years and that of patients with troponin-I levels >0.06 ng/ml was 60.13 ± 20.04 years. The nonsurvival rate was high in patients aged >50 years compared to the patients aged ≤50 years (81.4% vs. 18.6%; P < 0.001). The mortality rate was high in patients with troponin-I levels >0.06 ng/ml compared to the patients with troponin-I levels ≤0.06 ng/ml (51.7% vs. 48.3%; P < 0.001). Breathlessness (odds ratio [OR]: 26.901; P < 0.001), cut-off troponin-I levels (OR: 8.246; P < 0.001), and other comorbidities (OR: 8.246; P < 0.001) were independently correlated with mortality among hospitalized patients with COVID-19. Conclusion: This study demonstrated that elevated troponin-I level at presentation was associated with disease severity and increased mortality in patients with COVID-19.