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Characterization of Myocardial Injury in Patients With COVID-19.
Giustino, Gennaro; Croft, Lori B; Stefanini, Giulio G; Bragato, Renato; Silbiger, Jeffrey J; Vicenzi, Marco; Danilov, Tatyana; Kukar, Nina; Shaban, Nada; Kini, Annapoorna; Camaj, Anton; Bienstock, Solomon W; Rashed, Eman R; Rahman, Karishma; Oates, Connor P; Buckley, Samantha; Elbaum, Lindsay S; Arkonac, Derya; Fiter, Ryan; Singh, Ranbir; Li, Emily; Razuk, Victor; Robinson, Sam E; Miller, Michael; Bier, Benjamin; Donghi, Valeria; Pisaniello, Marco; Mantovani, Riccardo; Pinto, Giuseppe; Rota, Irene; Baggio, Sara; Chiarito, Mauro; Fazzari, Fabio; Cusmano, Ignazio; Curzi, Mirko; Ro, Richard; Malick, Waqas; Kamran, Mazullah; Kohli-Seth, Roopa; Bassily-Marcus, Adel M; Neibart, Eric; Serrao, Gregory; Perk, Gila; Mancini, Donna; Reddy, Vivek Y; Pinney, Sean P; Dangas, George; Blasi, Francesco; Sharma, Samin K; Mehran, Roxana.
  • Giustino G; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York. Electronic address: gennaro.giustino@mountsinai.org.
  • Croft LB; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Stefanini GG; Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy. Electronic address: giulio.stefanini@gmail.com.
  • Bragato R; Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy.
  • Silbiger JJ; Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Vicenzi M; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Dyspnea Lab, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
  • Danilov T; Mount Sinai Beth Israel Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Kukar N; Mount Sinai West Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Shaban N; Mount Sinai Queens Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Kini A; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Camaj A; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Bienstock SW; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Rashed ER; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York; Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Rahman K; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Oates CP; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Buckley S; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Elbaum LS; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York; Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Arkonac D; Mount Sinai Beth Israel Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Fiter R; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Singh R; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Li E; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Razuk V; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Robinson SE; Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Miller M; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Bier B; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Donghi V; Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy.
  • Pisaniello M; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
  • Mantovani R; Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy.
  • Pinto G; Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy.
  • Rota I; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
  • Baggio S; Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy.
  • Chiarito M; Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy.
  • Fazzari F; Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy.
  • Cusmano I; Dyspnea Lab, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
  • Curzi M; Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy.
  • Ro R; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Malick W; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Kamran M; Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Kohli-Seth R; Institute for Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Bassily-Marcus AM; Institute for Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Neibart E; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Serrao G; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Perk G; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Mancini D; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Reddy VY; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Pinney SP; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Dangas G; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Blasi F; University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy.
  • Sharma SK; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
  • Mehran R; The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
J Am Coll Cardiol ; 76(18): 2043-2055, 2020 11 03.
Article in English | MEDLINE | ID: covidwho-887081
ABSTRACT

BACKGROUND:

Myocardial injury is frequent among patients hospitalized with coronavirus disease-2019 (COVID-19) and is associated with a poor prognosis. However, the mechanisms of myocardial injury remain unclear and prior studies have not reported cardiovascular imaging data.

OBJECTIVES:

This study sought to characterize the echocardiographic abnormalities associated with myocardial injury and their prognostic impact in patients with COVID-19.

METHODS:

We conducted an international, multicenter cohort study including 7 hospitals in New York City and Milan of hospitalized patients with laboratory-confirmed COVID-19 who had undergone transthoracic echocardiographic (TTE) and electrocardiographic evaluation during their index hospitalization. Myocardial injury was defined as any elevation in cardiac troponin at the time of clinical presentation or during the hospitalization.

RESULTS:

A total of 305 patients were included. Mean age was 63 years and 205 patients (67.2%) were male. Overall, myocardial injury was observed in 190 patients (62.3%). Compared with patients without myocardial injury, those with myocardial injury had more electrocardiographic abnormalities, higher inflammatory biomarkers and an increased prevalence of major echocardiographic abnormalities that included left ventricular wall motion abnormalities, global left ventricular dysfunction, left ventricular diastolic dysfunction grade II or III, right ventricular dysfunction and pericardial effusions. Rates of in-hospital mortality were 5.2%, 18.6%, and 31.7% in patients without myocardial injury, with myocardial injury without TTE abnormalities, and with myocardial injury and TTE abnormalities. Following multivariable adjustment, myocardial injury with TTE abnormalities was associated with higher risk of death but not myocardial injury without TTE abnormalities.

CONCLUSIONS:

Among patients with COVID-19 who underwent TTE, cardiac structural abnormalities were present in nearly two-thirds of patients with myocardial injury. Myocardial injury was associated with increased in-hospital mortality particularly if echocardiographic abnormalities were present.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Ventricular Dysfunction / Heart / Myocardium Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America / Europa Language: English Journal: J Am Coll Cardiol Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Ventricular Dysfunction / Heart / Myocardium Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America / Europa Language: English Journal: J Am Coll Cardiol Year: 2020 Document Type: Article