A Study on electrographic abnormalities and troponin elevation in COVID-19 patients: A Bangladeshi Perspective

Background: In Bangladesh, COVID-19 patients frequently present with electrographic abnormalities and elevated troponin levels, indicative of cardiac stress. These observations highlight the virus's potential impact on cardiovascular health, necessitating vigilant monitoring and timely interventions to mitigate complications. Study Objective: This research aims to assess electrographic abnormalities and troponin elevation in COVID-19 patients within Bangladesh. Methods: Conducted retrospectively at a tertiary medical college and hospital, our study enrolled 100 consecutive adult COVID-19 patients. We analyzed baseline characteristics, lab results, and serial ECGs. Troponin I concentrations were measured using the Abbott Architect method (normal range: ≤0.05 ng/mL). Troponin levels were categorized as normal (0.00-0.05 ng/mL), mildly elevated (0.05-1 ng/mL), and significantly elevated (>1 ng/mL). ECGs were reviewed and interpreted. Results: The majority of patients (71%) were males aged 41-50. Common COVID-19 symptoms included dyspnea and cough (75%), followed by fever, fatigue, and malaise (80%). Gastrointestinal symptoms were seen in 20%, and 10% experienced anosmia or dysgeusia. Comorbidities included diabetes mellitus (65%), hypertension (60%), CKD (10%), coronary artery diseases (13%), and other cardiovascular diseases (5%). Abnormal LFTs were observed in 30%. Initial troponin levels averaged 0.18 ± 1.75 ng/mL, with a maximum of 2.55 ± 17.90 ng/mL. Mortality occurred in 25% of cases. Conclusion: Our findings suggest that ECG repolarization abnormalities may serve as markers of clinical severity, even in cases with mildly elevated troponin values in COVID-19 patients.