Comparative frequency and prognostic impact of myocardial injury in hospitalized patients with COVID-19 and Influenza.

Aims: Myocardial injury (MINJ) in Coronavirus disease 2019 (COVID-19) identifies individuals at high mortality risk but its clinical relevance is less well established for Influenza and no comparative analyses evaluating frequency and clinical implications of MINJ among hospitalized patients with Influenza or COVID-19 are available. Methods and results: Hospitalized adults with laboratory confirmed Influenza A or B or COVID-19 underwent highly sensitive cardiac T Troponin (hs-cTnT) measurement at admission in four regional hospitals in Canton Ticino, Switzerland. MINJ was defined as hs-cTnT >14 ng/L. Clinical, laboratory and outcome data were retrospectively collected. The primary outcome was mortality up to 28 days. Cox regression models were used to assess correlations between admission diagnosis, MINJ, and mortality. Clinical correlates of MINJ in both viral diseases were also identified. MINJ occurred in 94 (65.5%) out of 145 patients hospitalized for Influenza and 216 (47.8%) out of 452 patients hospitalized for COVID-19. Advanced age and renal impairment were factors associated with MINJ in both diseases. At 28 days, 7 (4.8%) deaths occurred among Influenza and 76 deaths (16.8%) among COVID-19 patients with a hazard ratio (HR) of 3.69 [95% confidence interval (CI) 1.70-8.00]. Adjusted Cox regression models showed admission diagnosis of COVID-19 [HR 6.41 (95% CI 4.05-10.14)] and MINJ [HR 8.01 (95% CI 4.64-13.82)] to be associated with mortality. Conclusions: Myocardial injury is frequent among both viral diseases and increases the risk of death in both COVID-19 and Influenza. The absolute risk of death is considerably higher in patients admitted for COVID-19 when compared with Influenza.

The impact of the COVID-19 pandemic upon patients, staff, and on the future practices of percutaneous coronary intervention.

The COVID pandemic in 2020 had unpredictable consequences on the presentation and management of patients with ischaemic heart disease. Subsequent to these initial responses the impact of the initial pandemic can be reviewed and responses can be considered. It is clear that there are new opportunities for optimising patient management pathways and in particular enhanced use of information technology. Changes in attitudes towards health and perceived risk are evident within both the catheter lab teams and our patient cohorts. Summating both the intellectual and emotional experiences of the pandemic are essential to prepare for either a second wave of COVID 19 or any new pandemic threat in the future.