tetano
Editor, Senior Moderator
Int J Cardiol
. 2020 Sep 23;S0167-5273(20)33829-8.
doi: 10.1016/j.ijcard.2020.09.048. Online ahead of print.
Myocardial injury and risk factors for mortality in patients with COVID-19 pneumonia
Chongtu YangMD[SUP] 1 [/SUP], Fen LiuMD[SUP] 2 [/SUP], Wei LiuMD[SUP] 3 [/SUP], Guijuan CaoMD[SUP] 4 [/SUP], Jiacheng LiuMD[SUP] 1 [/SUP], Songjiang HuangMD[SUP] 1 [/SUP], Muxin ZhuMD[SUP] 3 [/SUP], Chao TuMD[SUP] 5 [/SUP], Jianwen WangMD[SUP] 3 [/SUP], Bin XiongPhD[SUP] 6 [/SUP]
Affiliations
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.
Methods: 224 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: 203 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 SaO[SUB]2[/SUB]. 28 (50%) non-survivors and 9 (6%) survivors developed myocardial injury, which was associated with disease severity at admission. Elevated d-dimer (OR = 9.51, 95% CI [3.61-25.0], P < 0.001), creatinine kinase-myocardial band (OR = 6.93, 95% CI [1.83-26.2], P = 0.004), Troponin I (OR = 10.1, 95% CI [3.1-32.8], P < 0.001) and C-reactive protein (OR = 15.1, 95% CI [1.7-129.3], P = 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: Biomarkers; Coronavirus disease 2019; Mortality; Myocardial injury; Pneumonia.
. 2020 Sep 23;S0167-5273(20)33829-8.
doi: 10.1016/j.ijcard.2020.09.048. Online ahead of print.
Myocardial injury and risk factors for mortality in patients with COVID-19 pneumonia
Chongtu YangMD[SUP] 1 [/SUP], Fen LiuMD[SUP] 2 [/SUP], Wei LiuMD[SUP] 3 [/SUP], Guijuan CaoMD[SUP] 4 [/SUP], Jiacheng LiuMD[SUP] 1 [/SUP], Songjiang HuangMD[SUP] 1 [/SUP], Muxin ZhuMD[SUP] 3 [/SUP], Chao TuMD[SUP] 5 [/SUP], Jianwen WangMD[SUP] 3 [/SUP], Bin XiongPhD[SUP] 6 [/SUP]
Affiliations
- PMID: 32979425
- DOI: 10.1016/j.ijcard.2020.09.048
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.
Methods: 224 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: 203 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 SaO[SUB]2[/SUB]. 28 (50%) non-survivors and 9 (6%) survivors developed myocardial injury, which was associated with disease severity at admission. Elevated d-dimer (OR = 9.51, 95% CI [3.61-25.0], P < 0.001), creatinine kinase-myocardial band (OR = 6.93, 95% CI [1.83-26.2], P = 0.004), Troponin I (OR = 10.1, 95% CI [3.1-32.8], P < 0.001) and C-reactive protein (OR = 15.1, 95% CI [1.7-129.3], P = 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: Biomarkers; Coronavirus disease 2019; Mortality; Myocardial injury; Pneumonia.