Investigation roles of cardiac biomarkers (Troponine I and Myoglobin) and vitamin D in pathogenisis of COVID-19 in Iraqi population

Abstract

The new coronavirus pneumonia of 2019 (COVID-19) pandemic has claimed the lives of millions of people worldwide. Troponin has long been known to indicate a patient’s condition. Myoglobin serves as a biomarker for general muscle pain as well as a biomarker for myocardial infarction. COVID-19 is a known immunosuppressant, whereas vitamin D is a well-known immunomodulator. A total of 90 blood samples (50 from COVID-19 patients and 40 from healthy individuals) were collected from the Al-Shifa Center (which accommodates sleeping COVID-19 patients) at Baquba Teaching Hospital in Diyala Governorate during the period from the beginning of April to the end of May 2021. Troponin I, Myoglobin, and vitamin D levels were assessed using an immunoassay analyzer system with several functions (Opus, Dade Behring Diagnostics). The results show a significant difference between age groups and study groups, as well as between heart disease patients and study groups. Gender does not have a significant effect on diseases. Troponin I and Myoglobin markers were significantly higher in patients compared to healthy individuals (41 out of 50 vs. 3 out of 40 (OR=35.44) and 42 out of 50 vs. 2 out of 40 (OR=45.32), respectively). In contrast, the results show lower levels of vitamin D in patients than in healthy individuals (47 out of 50 vs. 5 out of 40 (OR=0.001)) with a significant difference (p>0.05). Current results discovered elevated levels of Troponin I and Myoglobin markers and reduced levels of vitamin D in patients with heart diseases compared to healthy individuals without heart diseases, with a significant difference. This study of Troponin I and Myoglobin markers revealed high sensitivity of Troponin I (AUC=0.991 and Sn=100%) and Myoglobin (AUC=0.999 and Sn=100%) and very low sensitivity (AUC=0.001 and Sn=0.1%) in screening for COVID-19 with a significant difference (P<0.05). Finally, the results show a positive and significant correlation between Troponin I and Myoglobin (r = 0.329 ∗ , p < 0.05), as well as a negative correlation between vitamin D and Troponin I, and between vitamin D and Myoglobin (r = −0.143, p > 0.05, and r = −0.037, p > 0.05, respectively). In conclusion, age and heart diseases are risk factors for COVID-19. Cardiac Biomarkers Troponin I and Myoglobin are predictive risk markers related to mortality and are highly correlated with heart failure in COVID-19 disease. Vitamin D supplementation reduces thrombosis and cytokine storm in COVID-19 patients.