Elevated hs TROPONIN -I in RT-PCR Positive COVID-19 Patients without Cardiac Symptoms

The global pandemic caused by coronavirus disease 2019 (COVID-19) has affected more than 60,000, 000 people in over 220 countries or regions worldwide. COVID-19 is the clinical manifestation of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and most frequently presents with symptoms of cough , cold ,fever that can progress to pneumonia and, in severe cases, acute respiratory distress syndrome and shock. However, there is increasing awareness of the cardiovascular manifestations of COVID-19 disease. Discriminating between a cardiac or respiratory etiology of symptoms can be challenging since each may present predominantly with dyspnea. It is also critical to recognize when cardiac and pulmonary involvement coexist. Pre-existing cardiovascular disease seems to be linked with worse outcomes and increased risk of death in patients with COVID-19, whereas COVID-19 itself can also induce myocardial injury, arrhythmia, acute coronary syndrome and venous thromboembolism. Potential drug?disease interactions affecting patients with COVID-19 and comorbid cardiovascular diseases are also becoming a serious concern. SARS-CoV-2. However, in addition to respiratory symptoms, uncontrolled SARS-CoV-2 infection can trigger a cytokine storm, whereby pro-inflammatory cytokines and chemokines such as tumour necrosis factor-?, IL-1? and IL-6 are overproduced by the immune system, resulting in multiorgan damage. Furthermore, COVID-19 causes coagulation abnormalities in a substantial proportion of patients, which can lead to thromboembolic events .The myocardial injury is identified by Cardiac bio markers like hs Troponin I and BNP , pro BNP. These markers are elevated in covid 19 disease and also important in prognostic value, but many covid 19 RT- PCR positive patients ts will not have significant symptoms. Inspite of absence of symptoms some patients will have raised values of hs Troponin, this signifies subclinical myocardial damage which has to be followed for long term Cardiovascular complications of COVID 19 disease.