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Risk factors for myocardial injury in patients with coronavirus disease 2019 in China.
Fan, Qin; Zhu, Hongling; Zhao, Jiaxin; Zhuang, Lingfang; Zhang, Hang; Xie, Hongyang; Zhang, Ruiyan; Granada, Juan F; Xiang, Xiaogang; Hu, Weiguo; Yan, Xiaoxiang.
  • Fan Q; Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, China.
  • Zhu H; Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai, China.
  • Zhao J; Department of Cardiology, Wuhan Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
  • Zhuang L; Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, China.
  • Zhang H; Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai, China.
  • Xie H; Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, China.
  • Zhang R; Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai, China.
  • Granada JF; Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, China.
  • Xiang X; Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai, China.
  • Hu W; Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, China.
  • Yan X; Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai, China.
ESC Heart Fail ; 7(6): 4108-4117, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-812761
ABSTRACT

AIMS:

In patients with coronavirus disease 2019 (COVID-19), the involvement of the cardiovascular system significantly relates to poor prognosis. However, the risk factors for acute myocardial injury have not been sufficiently studied. Thus, we aimed to determine the characteristics of myocardial injury and define the association between routine blood markers and cardiac troponin I, in order to perform a predictive model. METHODS AND

RESULTS:

This retrospective cohort study included patients with confirmed COVID-19 from Wuhan Tongji Hospital (Wuhan, China). Data were compared between those with and without myocardial injury. Kaplan-Meier analysis and Cox regression models were used to describe the association between myocardial injury and poor prognosis. Simple correlation analyses were used to find factors associated with high-sensitivity cardiac troponin I levels. Univariate and multivariate logistic regression methods were used to explore the risk factors associated with myocardial injury. The area under the receiver operating characteristic curve was used to determine the predictive value of the model. Of 353 patients included in the study, 79 presented myocardial injury. Patients with myocardial injury had higher levels of inflammation markers, poorer liver and kidney function, and more complications compared with patients without myocardial injury. High-sensitivity cardiac troponin I levels were significantly associated with neutrophil/lymphocyte ratio, creatinine, d-dimer, lactate dehydrogenase, and inflammatory cytokines and negatively associated with oxygen saturation. It was significantly associated with poor prognosis after adjusting for age, sex, and complications. Multivariate regression showed that myocardial injury was associated with a high neutrophil/lymphocyte ratio (odds ratio 2.30, 95% CI 1.11-4.75, per standard deviation increase, P = 0.02), creatinine (3.58, 1.35-8.06, P = 0.01), and lactate dehydrogenase (3.39, 1.42-8.06, P = 0.01) levels. Using a predictive model, the area under the receiver operating characteristic curve was 0.92 (0.88-0.96).

CONCLUSIONS:

In patients with COVID-19, neutrophil/lymphocyte ratio, creatinine, and lactate dehydrogenase are blood markers that could help identify patients with a high risk of myocardial injury at an early stage.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: ESC Heart Fail Year: 2020 Document Type: Article Affiliation country: Ehf2.13022

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: ESC Heart Fail Year: 2020 Document Type: Article Affiliation country: Ehf2.13022