tetano
Editor, Senior Moderator
Arch Cardiovasc Dis
. 2022 Jun 8;S1875-2136(22)00118-8.
doi: 10.1016/j.acvd.2022.04.008. Online ahead of print.
Cardiopulmonary predictors of mortality in patients with COVID-19: What are the findings?
Hoda Kavosi[SUP] 1 [/SUP], Sepehr Nayebi Rad[SUP] 2 [/SUP], Reza Atef Yekta[SUP] 3 [/SUP], Zahra Tamartash[SUP] 1 [/SUP], Mahboubeh Dini[SUP] 4 [/SUP], Zahra Javadi Nejad[SUP] 1 [/SUP], Leila Aghaghazvini[SUP] 5 [/SUP], Ali Javinani[SUP] 1 [/SUP], Amir Mohammad Mohammadzadegan[SUP] 1 [/SUP], Seyedeh Zahra Fotook Kiaei[SUP] 6 [/SUP]
Affiliations
Abstract
Background: Since 2019, coronavirus disease 2019 (COVID-19) has been the leading cause of mortality worldwide.
Aims: To determine independent predictors of mortality in COVID-19, and identify any associations between pulmonary disease severity and cardiac involvement.
Methods: Clinical, laboratory, electrocardiography and computed tomography (CT) imaging data were collected from 389 consecutive patients with COVID-19. Patients were divided into alive and deceased groups. Independent predictors of mortality were identified. Kaplan-Meier analysis was performed, based on patients having a troponin concentration>99th percentile (cardiac injury) and a CT severity score ≥18.
Results: The mortality rate was 29.3%. Cardiac injury (odds ratio [OR] 2.19, 95% confidence interval [CI] 1.14-4.18; P=0.018), CT score ≥18 (OR 2.24, 95% CI 1.15-4.34; P=0.017), localized ST depression (OR 3.77, 95% CI 1.33-10.67; P=0.012), hemiblocks (OR 3.09, 95% CI 1.47-6.48; P=0.003) and history of leukaemia/lymphoma (OR 3.76, 95% CI 1.37-10.29; P=0.010) were identified as independent predictors of mortality. Additionally, patients with cardiac injury and CT score ≥ 18 were identified to have a significantly shorter survival time (mean 14.21 days, 95% CI 10.45-17.98 days) than all other subgroups. There were no associations between CT severity score and electrocardiogram or cardiac injury in our results.
Conclusions: Our findings suggest that using CT imaging and electrocardiogram characteristics together can provide a better means of predicting mortality in patients with COVID-19. We identified cardiac injury, CT score ≥18, presence of left or right hemiblocks on initial electrocardiogram, localized ST depression and history of haematological malignancies as independent predictors of mortality in patients with COVID-19.
Keywords: Atteinte myocardique; COVID-19; CT score; Cardiac injury; Electrocardiography; Score calcique pulmonaire; Troponin; Électrocardiogramme; Élévation de la troponine.
. 2022 Jun 8;S1875-2136(22)00118-8.
doi: 10.1016/j.acvd.2022.04.008. Online ahead of print.
Cardiopulmonary predictors of mortality in patients with COVID-19: What are the findings?
Hoda Kavosi[SUP] 1 [/SUP], Sepehr Nayebi Rad[SUP] 2 [/SUP], Reza Atef Yekta[SUP] 3 [/SUP], Zahra Tamartash[SUP] 1 [/SUP], Mahboubeh Dini[SUP] 4 [/SUP], Zahra Javadi Nejad[SUP] 1 [/SUP], Leila Aghaghazvini[SUP] 5 [/SUP], Ali Javinani[SUP] 1 [/SUP], Amir Mohammad Mohammadzadegan[SUP] 1 [/SUP], Seyedeh Zahra Fotook Kiaei[SUP] 6 [/SUP]
Affiliations
- PMID: 35752584
- DOI: 10.1016/j.acvd.2022.04.008
Abstract
Background: Since 2019, coronavirus disease 2019 (COVID-19) has been the leading cause of mortality worldwide.
Aims: To determine independent predictors of mortality in COVID-19, and identify any associations between pulmonary disease severity and cardiac involvement.
Methods: Clinical, laboratory, electrocardiography and computed tomography (CT) imaging data were collected from 389 consecutive patients with COVID-19. Patients were divided into alive and deceased groups. Independent predictors of mortality were identified. Kaplan-Meier analysis was performed, based on patients having a troponin concentration>99th percentile (cardiac injury) and a CT severity score ≥18.
Results: The mortality rate was 29.3%. Cardiac injury (odds ratio [OR] 2.19, 95% confidence interval [CI] 1.14-4.18; P=0.018), CT score ≥18 (OR 2.24, 95% CI 1.15-4.34; P=0.017), localized ST depression (OR 3.77, 95% CI 1.33-10.67; P=0.012), hemiblocks (OR 3.09, 95% CI 1.47-6.48; P=0.003) and history of leukaemia/lymphoma (OR 3.76, 95% CI 1.37-10.29; P=0.010) were identified as independent predictors of mortality. Additionally, patients with cardiac injury and CT score ≥ 18 were identified to have a significantly shorter survival time (mean 14.21 days, 95% CI 10.45-17.98 days) than all other subgroups. There were no associations between CT severity score and electrocardiogram or cardiac injury in our results.
Conclusions: Our findings suggest that using CT imaging and electrocardiogram characteristics together can provide a better means of predicting mortality in patients with COVID-19. We identified cardiac injury, CT score ≥18, presence of left or right hemiblocks on initial electrocardiogram, localized ST depression and history of haematological malignancies as independent predictors of mortality in patients with COVID-19.
Keywords: Atteinte myocardique; COVID-19; CT score; Cardiac injury; Electrocardiography; Score calcique pulmonaire; Troponin; Électrocardiogramme; Élévation de la troponine.