# Trajectory of cardiac troponin T following moderate-to-severe COVID-19 and the association with cardiac abnormalities

## TL;DR

This study examines how cardiac troponin T levels change after moderate-to-severe COVID-19 and their link to heart abnormalities.

## Contribution

The study identifies the trajectory of hs-cTnT and its association with cardiac abnormalities in post-COVID-19 patients.

## Key findings

- Hs-cTnT levels decreased from hospitalization to 3 months but remained stable afterward.
- Low hs-cTnT concentrations (<5 ng/L) at 3 months had a high negative predictive value for cardiac abnormalities.
- Cardiac abnormalities were more common in patients with higher hs-cTnT levels during the convalescent phase.

## Abstract

COVID-19 has been associated with cardiac troponin T (cTnT) elevations and changes in cardiac structure and function, but the link between cardiac dysfunction and high-sensitive cardiac troponin T (hs-cTnT) in the acute and convalescent phase is unclear.

To assess whether hs-cTnT concentrations are associated with cardiac dysfunction and structural abnormalities after hospitalization for COVID-19, and to evaluate the performance of hs-cTnT to rule out cardiac pathology.

Patients hospitalized with COVID-19 had hs-cTnT measured during the index hospitalization and after 3-and 12 months, when they also underwent an echocardiographic study. A subset also underwent cardiovascular magnetic resonance imaging (CMR) after 6 months. Cardiac abnormalities were defined as left ventricular hypertrophy or dysfunction, right ventricular dysfunction, or CMR late gadolinium.

We included 189 patients with hs-cTnT concentrations measured during hospitalization for COVID-19, and after 3-and 12 months: Geometric mean (95%CI) 13 (11–15) ng/L, 7 (6–8) ng/L and 7 (6–8) ng/L, respectively. Cardiac abnormalities after 3 months were present in 45 (30%) and 3 (8%) of patients with hs-cTnT ≥ and < 5 ng/L at 3 months, respectively (negative predictive value 92.3% [95%CI 88.5–96.1%]). The performance was similar in patients with and without dyspnea. Hs-cTnT decreased from hospitalization to 3 months (more pronounced in intensive care unit-treated patients) and remained unchanged from 3 to 12 months, regardless of the presence of cardiac abnormalities.

Higher hs-cTnT concentrations in the convalescent phase of COVID-19 are associated with the presence of cardiac pathology and low concentrations (< 5 ng/L) may support in ruling out cardiac pathology following the infection.

The online version contains supplementary material available at 10.1186/s12872-024-03854-7.