Mikail Yarlıoğlueş, Damla Yalçınkaya Öner, Hasan Yiğit, Uğur Bozkurt, Sani Namık Murat
Interventional Cardiology Perspectives - 2025;1(2):59-66
Background: Troponin and select inflammation biomarkers are associated with Coronavirus disease-2019 (COVID-19) severity and intensive care unit (ICU) admissions related to cardiac injury. However, cardiac magnetic resonance imaging (CMRI) remains the gold standard for detecting myocardial involvement. Aim: This study aimed to determine whether troponin levels at admission are associated with clinical severity and CMRI-confirmed cardiac injury. Study Design: A prospective, observational cohort study involving 51 recovered COVID-19 patients, categorized into ICU (n=16) and non-ICU (n=35) groups, and assessed 4-6 weeks postdischarge. Methods: Blood samples were collected during hospital admission to ascertain the levels of high-sensitivity cardiac troponin T (hs-cTnT), C-reactive protein (CRP), procalcitonin, neutrophil-to-lymphocyte ratio (NLR), D-dimer, ferritin, and systemic immune-inflammation index (SII). Patients also underwent electrocardiography (ECG), transthoracic echocardiography (TTE), and CMRI. Group differences were analyzed statistically, and receiver operating characteristic (ROC) curve analysis assessed biomarker predictive performance for ICU admission and cardiac injury. Results: ICU patients had considerably greater levels of inflammatory biomarkers and hs-cTnT (p<0.05). The ROC curve analysis revealed that hs-cTnT, NLR, D-dimer, ferritin, CRP , and SII levels predicted ICU admission (p<0.05). ECG and TTE findings were comparable between the groups. On CMRI, non-ischemic fibrosis was observed to be more prevalent in ICU patients (p=0.03). ROC curve revealed that hs-cTnT and SII levels predicted CMRI-detected cardiac injury (p<0.05). Conclusion: The troponin and SII levels at admission were associated with disease severity and CMRI-confirmed cardiac injury, even in the presence of normal echocardiographic findings. Both markers may help predict ICU necessity and serious cardiac involvement.
