Development of a nomogram to assess the impact of the myocardial injury on the prognosis of COVID-19 patients.

ABSTRACT

Coronavirus disease 2019 (COVID-19) has been spreading worldwide. Many COVID-19 patients were accompanied by myocardial injury during the course of the disease. To evaluate the association of cardiac injury with clinical outcomes in COVID-19 patients, we recruited 261 COVID-19 cases admitted to Tongji Hospital of Huazhong University of Science and Technology in this study. Compared with patients without myocardial injury, those with myocardial injury were older, with shorter hospital stays and lower survival rates. They also had higher levels of inflammatory biomarkers (Interleukin-6,8,10 and C-reactive protein), coagulation biomarkers, liver and kidney function markers. Kaplan-Meier analysis demonstrated that patients with myocardial injury had a higher mortality rate. The multivariate Cox regression model and the nomogram revealed that myocardial injury, co-morbidity, and abnormal procalcitonin (PCT) levels were independent risk factors of the mortality of COVID-19 patients. The linear correlation analysis and the ROC curve suggested a predictive value of the neutrophil-lymphocyte ratio (NLR) in cardiac injury. Summarily, myocardial injury in COVID-19 patients is associated with a higher mortality risk. Attention should be paid to monitoring myocardial injury in patients with significantly elevated myocardial markers and NLR at admission.