Purpose: Although most studies showed that the increase of cardiac biomarkers due to myocardial injury during coronavirus disease (COVID-19) is a strong predictor of adverse clinical events, few studies compared other causes of myocardial injury and COVID-19. In our study, cardiac biomarker levels were compared in patients who developed myocardial injury due to COVID-19 and other causes, and the relationship between elevated cardiac biomarkers and adverse clinical events during COVID-19 was examined.

Material and Methods: Data of 496 patients aged between 18 and 80 years, who performed one of hsTrl, CK-MB, myoglobin, and BNP between March 2020 and March 2022, didn’t have malignancy, renal failure requiring hemodialysis, or myocardial infarction, were retrospectively examined. Patients were divided into two groups as SARS-CoV-2 (+) (n:286) and SARS-CoV-2 (-) (n:210). Cardiac biomarkers were recorded. Intubation and death were defined as adverse clinical events; “myocardial injury” was defined as at least one hsTrI value exceeding 99% URL in the absence of myocardial ischemia. Data were analyzed with SPSS 21.

Results: Myocardial injury was significantly higher in the SARS-CoV-2(-) group (100% vs 48.9% p<0.001). Lower mean age; male gender dominance, having respiratory complaints and chronic diseases, need for mechanical ventilation; hsTrI and CK-MB elevations in death patients were observed significantly in the SARS-CoV-2 (+) group. After excluding the effects of age, gender, chronic disease, and vaccination, the predictive factors of demographic and clinical characteristics for myocardial damage were analysed by logistic regression. Accordingly, SARS-CoV-2 wasn’t a strong cause of myocardial injury when compared to other causes.

Conclusions: SARS-CoV-2 is not a significant cause of myocardial injury. However, myocardial injury during COVID-19 is associated with mortality.