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Infection
. 2020 Jul 28.
doi: 10.1007/s15010-020-01473-w. Online ahead of print.
Cardiac manifestations of COVID-19 in Shenzhen, China
Jia-Hui Zeng 1 , Wei-Bo Wu 2 , Jiu-Xin Qu 3 , Yao Wang 1 , Chang-Feng Dong 1 , Yong-Fang Luo 1 , Dan Zhou 1 , Wen-Xia Feng 1 , Cheng Feng 4
Affiliations
- PMID: 32725595
- DOI: 10.1007/s15010-020-01473-w
Abstract
Purpose: The coronavirus disease 2019 (COVID-19) outbreak has become a global public health concern; however, relatively few detailed reports of related cardiac injury are available. The aims of this study were to compare the clinical and echocardiographic characteristics of inpatients in the intensive-care unit (ICU) and non-ICU patients.
Methods: We recruited 416 patients diagnosed with COVID-19 and divided them into two groups: ICU (n = 35) and non-ICU (n = 381). Medical histories, laboratory findings, and echocardiography data were compared.
Results: The levels of myocardial injury markers in ICU vs non-ICU patients were as follows: troponin I (0.029 ng/mL [0.007-0.063] vs 0.006 ng/mL [0.006-0.006]) and myoglobin (65.45 μg/L [39.77-130.57] vs 37.00 μg/L [26.40-53.54]). Echocardiographic findings included ventricular wall thickening (12 [39%] vs 1 [4%]), pulmonary hypertension (9 [29%] vs 0 [0%]), and reduced left-ventricular ejection fraction (5 [16%] vs 0 [0%]). Overall, 10% of the ICU patients presented with right heart enlargement, thickened right-ventricular wall, decreased right heart function, and pericardial effusion. Cardiac complications were more common in ICU patients, including acute cardiac injury (21 [60%] vs 13 [3%]) (including 2 cases of fulminant myocarditis), atrial or ventricular tachyarrhythmia (3 [9%] vs 3 [1%]), and acute heart failure (5 [14%] vs 0 [0%]).
Conclusion: Myocardial injury marker elevation, ventricular wall thickening, pulmonary artery hypertension, and cardiac complications including acute myocardial injury, arrhythmia, and acute heart failure are more common in ICU patients with COVID-19. Cardiac injury in COVID-19 patients may be related more to the systemic response after infection rather than direct damage by coronavirus.
Keywords: COVID-19; Coronavirus; Echocardiography; Intensive-care unit; Myocarditis.