Role of Serum B-type Natriuretic Peptide, Cardiac Troponin I and Creatine kinase monophosphate levels in early detection of Cardiac dysfunction in COVID-19 infected patients

Background: Cardiac complications are a significant contributor to morbidity and mortality in COVID-19 patients. Early identification of cardiac dysfunction is critical for improving outcomes. This study aimed to evaluate the diagnostic and prognostic utility of serum B-type natriuretic peptide, cardiac troponin I, and creatine kinase-MB levels in detecting cardiac involvement among hospitalized COVID-19 patients. Methods: A prospective cross-sectional study was conducted on 280 severe or critically ill COVID-19 patients during the period from April 2022 to December 2023. Patients were classified into two groups: Group I (n = 72) with pre-existing cardiac disease and Group II (n = 208) without pre-existing cardiac insult. Patients underwent serial assessments of clinical status and cardiac biomarkers on Days 1, 3, and 7 of admission. Statistical comparisons and correlation analyses were performed. Results: Group I exhibited significantly elevated levels of CK-MB, troponin I, and BNP, particularly on Days 1 and 3 (p < 0.001), along with a higher incidence of ECG and echocardiographic abnormalities. BNP showed strong correlations with troponin and CK-MB (rₛ > 0.75, p < 0.001), indicating consistent myocardial dysfunction. ROC curve analysis on Day 1 showed moderate diagnostic accuracy for differentiating cardiac involvement: AUCs were 0.681 for CK-MB, 0.682 for troponin, and 0.693 for BNP. Mortality was significantly higher in Group I (72.2%) compared to Group II (49.5%) (p = 0.001). Conclusion: Serial measurement of BNP, troponin I, and CK-MB provides valuable insight into cardiac involvement in COVID-19 patients and can aid in early risk stratification and prognosis.