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Sci Rep . Comparison of risk factors and outcomes of raised vs normal cardiac troponin levels in COVID-19 patients: a retrospective study

tetano

Editor, Senior Moderator
Sci Rep


. 2025 Sep 29;15(1):33385.
doi: 10.1038/s41598-025-18397-w. Comparison of risk factors and outcomes of raised vs normal cardiac troponin levels in COVID-19 patients: a retrospective study

Ishfaque Ahmed[SUP] 1 [/SUP], Beenish Syed[SUP] 2 [/SUP], Muneeba Ahsan Sayeed[SUP] 3 [/SUP], Fizza Farooqui[SUP] 4 [/SUP], Uzair Abbas[SUP] 5 [/SUP], Saba Afshan[SUP] 3 [/SUP], Samreen Kulsoom Zaidi[SUP] 3 [/SUP], Shaiza Farman[SUP] 3 [/SUP], Mahtab Khan[SUP] 6 [/SUP], Niaz Hussain[SUP] 7 [/SUP], Mohammad Hadif[SUP] 6 [/SUP], Muhib Ullah Khalid[SUP] 6 [/SUP], Kashaf Fatima[SUP] 6 [/SUP], Muhammad Mubeen[SUP] 6 [/SUP]



Affiliations
Abstract

COVID-19 primarily affects the lungs, but it can also cause neurological, psychological, and cardiovascular complications. Myocardial injury and myocarditis are of significant concerns that are often indicated by elevated troponin levels, a marker of cardiac involvement. This study analyzed risk factors and outcome of elevated troponin-I levels in COVID-19 patients compared to those with normal levels. We included 766 COVID-19 patients of which 50.6% were female, and 74.2% having co-morbidities. Patients were divided into two groups: 383 with elevated troponin levels and 383 with normal levels. We compared their demographics, clinical characteristics and outcome to identify the risk factors for cardiac injury during COVID-19 infection. Data was analyzed through SPSS V.24. Patients with elevated troponin were predominantly male (63.7%) and younger (mean age 58.42 years) than those with normal levels (64.86 years). Despite having fewer co-morbidities and milder COVID-19 cases, participants with raised troponin had lower ICU admission (37.02% vs. 60.2%) and ARDS rates (38.78% vs. 61.2%), yet mortality rates were similar. Ejection fraction remained stable across groups, but Pro-BNP levels were significantly lower in those with raised troponin (8.4% vs. 91.5%). This study highlights significant associations between elevated troponin levels in COVID-19 patients and factors like male gender, comorbid conditions, and ARDS. However, contrary to other studies, higher troponin levels were often found in patients with less severe COVID-19 with negative association with pro-BNP levels. The findings suggest that elevated troponin in COVID-19 does not directly correlate with disease severity or mortality. Further research with longitudinal follow-up and more granular biomarker analysis is recommended to fully elucidate the relationship between troponin levels and cardiac outcomes in COVID-19 patients.

Keywords: COVID-19; Cardiac injury; Troponin levels.

 
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