Myocardial injury and risk factors for mortality in patients with COVID-19 pneumonia.
Int J Cardiol
; 326: 230-236, 2021 03 01.
Article
in English
| MEDLINE | ID: covidwho-803390
ABSTRACT
BACKGROUND:
Coronavirus disease 2019 (COVID-19) pneumonia tends to affect cardiovascular system and cause cardiovascular damage. This study aimed to explore the prevalence of myocardial injury and risk factors for mortality in patients with COVID-19 pneumonia.METHOD:
Two hundred and twenty-four consecutive patients with confirmed diagnosis of SARS-CoV-2 infection and definite outcomes (discharge or death) were retrospectively analyzed. Laboratory results including myocardial biomarkers, oxygen saturation, inflammatory indicators and coagulation function were compared between survivors and non-survivors. Univariate and multivariate logistic regression model were used to explore risk factors for in-hospital mortality, and a chart with different combinations of risk factors was constructed to predict mortality.RESULTS:
Two hundred and three patients were included in the final analysis, consisting of 145 patients who recovered and 58 patients who died. Compared with survivors, non-survivors were older, with more comorbidities, more severe inflammation and active coagulation function, higher levels of myocardial biomarkers and lower SaO2. 28 (50%) non-survivors and 9 (6%) survivors developed myocardial injury, which was associated with disease severity at admission. Elevated d-dimer (ORâ¯=â¯9.51, 95% CI [3.61-25.0], Pâ¯<â¯0.001), creatinine kinase-myocardial band (ORâ¯=â¯6.93, 95% CI [1.83-26.2], Pâ¯=â¯0.004), Troponin I (ORâ¯=â¯10.1, 95% CI [3.1-32.8], Pâ¯<â¯0.001) and C-reactive protein (ORâ¯=â¯15.1, 95% CI [1.7-129.3], Pâ¯=â¯0.013) were risk factors for mortality. Patients with abnormal levels of d-dimer, Troponin I and CRP were predicted to have significantly higher probability of death.CONCLUSIONS:
Our results suggest that SARS-CoV-2 infection may induce myocardial injury and consequently exacerbate the clinical course and worsen prognosis. Abnormal d-dimer, CK-MB, Troponin I and CRP are risk factors for short-term mortality.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Inflammation Mediators
/
COVID-19
/
Cardiomyopathies
Type of study:
Cohort study
/
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
Language:
English
Journal:
Int J Cardiol
Year:
2021
Document Type:
Article
Affiliation country:
J.ijcard.2020.09.048
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