Supervisors info:
Ξάνθος Θεόδωρος, Καθηγητής, Τμήμα Μαιευτικής, ΠΑΔΑ
Ιακωβίδου Νικολέττα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Εκμεκτζόγλου Κωνσταντίνος, Επ. Καθηγητής, Τμήμα Ιατρικής, Ευρωπαϊκό Πανεπιστήμιο Κύπρου
Summary:
Introduction: Cardiovascular complications of COVID-19 infection are associated with high morbidity and mortality even in the absence of cardiovascular disease or risk factors and can be identified by measuring troponin levels.
Purpose: The purpose of this retrospective study was to investigate the role of elevated troponin during COVID-19 infection in the occurrence of cardiac complications and outcome in hospitalized patients without a medical history of coronary artery disease. A secondary objective was to identify potential risk factors for troponin elevation among these patients.
Material and Method: The sample of the study consisted of 87 hospitalized patients with confirmed COVID-19 infection, without a medical history of coronary artery disease, who were hospitalized at the University General Hospital “ATTIKON”, between March 2020 and March 2023. The data were collected from the patients’ medical files, after obtaining permission from the hospital’s scientific board (no.ΕΒΔ778/21-12-2022), through a form, which included demographic and medical characteristics, hospitalization characteristics, selected biomarkers, as well as the outcome of the patients. The statistical analysis of the data was performed using the SPPSv25 statistical package and the statistical significance was set at <0.05.
Results: The mean age of the patients was 65.4±16.9 years, with 80.5% having concomitant diseases, mainly hypertension, diabetes mellitus and dyslipidemia, of which 34.3% had three comorbidities. The majority of the patients were hospitalized in the Intensive Care Unit (ICU). The mean troponin value was 739.2±1,458.8 pg/mL and the main cardiac complications were STEMI (28.7%), NSTEMI (23%), atrial fibrillation (18.4%), Takotsubo cardiomyopathy (10.3%), cardiac arrest (13.8%), cardiogenic shock (11.55) and acute myocarditis (8%). A positive correlation was found between troponin values and the incidence of STMI (p=<0.01), ventricular tachycardia (p=<0.05), cardiogenic shock and the number of cardiac complications (p=<0.01). Patients with STEMI had significantly higher troponin values compared to other cardiac complications (p=0.017), while for supraventricular tachycardia (p=0.000), atrioventricular block (p=0.001), tachyarrhythmia (p=0.006), acute pericarditis (p=0.003), heart failure (p=0.000), and right bundle branch block (p=0.003), troponin values were lower compared to other complications. Mortality was found at 57.5% but no correlation was found between troponin levels and patients’ outcome, and the same was observed with inflammatory markers or traditional markers of cardiovascular risk factors. However, smoking was found to be a predictive factor of troponin values (p=0.040).
Conclusions: Troponin is an important biomarker for the identification of cardiac complications due to COVID-19 among patients without known coronary artery diseases, and therefore its regular measurement in these patients can help in the prompt management of adverse cardiac events, reducing the morbidity and mortality associated with them, due to COVID-19 infection.
Keywords:
Troponin, COVID-19 Infection, Cardiac complications, Hospitalized patients
