tetano
Editor, Senior Moderator
J Am Heart Assoc
. 2020 Aug 18;e016807.
doi: 10.1161/JAHA.120.016807. Online ahead of print.
Clinical Characteristics and Risk Factors of Cardiac Involvement in COVID-19
Huayan Xu[SUP] 1 [/SUP], Keke Hou[SUP] 2 [/SUP], Rong Xu[SUP] 1 [/SUP], Zhenlin Li[SUP] 3 [/SUP], Hang Fu[SUP] 1 [/SUP], Lingyi Wen[SUP] 1 [/SUP], Linjun Xie[SUP] 1 [/SUP], Hui Liu[SUP] 1 [/SUP], Joseph B Selvanayagam[SUP] 4 [/SUP], Na Zhang[SUP] 2 [/SUP], Zhigang Yang[SUP] 3 [/SUP], Ming Yang[SUP] 5 [/SUP], Yingkun Guo[SUP] 1 [/SUP]
Affiliations
Abstract
Background Increasing studies demonstrated that the cardiac involvements are related to Coronavirus Disease 2019 (COVID-19). Thus, we investigated the clinical characteristics of COVID-19 patients and further determined the risk factors for cardiac involvements in them. Methods and Results We analyzed data from 102 consecutive laboratory-confirmed and hospitalized COVID-19 patients (52 women; age, 19-87 years). Epidemiological and demographic characteristics, clinical features, routine laboratory tests (including cardiac injury biomarkers), echocardiography, electrocardiography, chest imaging findings, management methods, and clinical outcomes were collected. Patients were divided into acute cardiac injury (ACI), with and without cardiac marker abnormities groups according to different level of cardiac markers. In this research, cardiac involvements were found in 72 of the 102 (70.6%) patients: tachycardia (n=20), electrocardiography abnormities (n=23), echocardiography abnormities (n=59), elevated myocardial enzymes (n=55), and acute myocardial injury (n=9). Eight ACI patients were aged >60 years; seven of them had two or more underlying comorbidities (hypertension, diabetes, cardiovascular diseases, chronic obstructive pulmonary disease and chronic kidney disease). Novel coronavirus pneumonia (NCP) was much more severe in the ACI patients than in patients with non-definite ACI (p<0.001). Multivariate analyses showed that C-reactive protein (CRP) levels, old age, NCP severity, and underlying comorbidities were the risk factors for cardiac abnormalities in COVID-19 patients. Conclusions Cardiac involvements are common in COVID-19 patients. Elevated CRP levels, old age, underlying comorbidities, and NCP severity are the main risk factors for cardiac involvement in COVID-19 patients. More attention should be given to cardiovascular protection during COVID-19 treatment for mortality reduction.
Keywords: COVID‐19; Cardiac involvement; acute cardiac injury; risk factor.
. 2020 Aug 18;e016807.
doi: 10.1161/JAHA.120.016807. Online ahead of print.
Clinical Characteristics and Risk Factors of Cardiac Involvement in COVID-19
Huayan Xu[SUP] 1 [/SUP], Keke Hou[SUP] 2 [/SUP], Rong Xu[SUP] 1 [/SUP], Zhenlin Li[SUP] 3 [/SUP], Hang Fu[SUP] 1 [/SUP], Lingyi Wen[SUP] 1 [/SUP], Linjun Xie[SUP] 1 [/SUP], Hui Liu[SUP] 1 [/SUP], Joseph B Selvanayagam[SUP] 4 [/SUP], Na Zhang[SUP] 2 [/SUP], Zhigang Yang[SUP] 3 [/SUP], Ming Yang[SUP] 5 [/SUP], Yingkun Guo[SUP] 1 [/SUP]
Affiliations
- PMID: 32806998
- DOI: 10.1161/JAHA.120.016807
Abstract
Background Increasing studies demonstrated that the cardiac involvements are related to Coronavirus Disease 2019 (COVID-19). Thus, we investigated the clinical characteristics of COVID-19 patients and further determined the risk factors for cardiac involvements in them. Methods and Results We analyzed data from 102 consecutive laboratory-confirmed and hospitalized COVID-19 patients (52 women; age, 19-87 years). Epidemiological and demographic characteristics, clinical features, routine laboratory tests (including cardiac injury biomarkers), echocardiography, electrocardiography, chest imaging findings, management methods, and clinical outcomes were collected. Patients were divided into acute cardiac injury (ACI), with and without cardiac marker abnormities groups according to different level of cardiac markers. In this research, cardiac involvements were found in 72 of the 102 (70.6%) patients: tachycardia (n=20), electrocardiography abnormities (n=23), echocardiography abnormities (n=59), elevated myocardial enzymes (n=55), and acute myocardial injury (n=9). Eight ACI patients were aged >60 years; seven of them had two or more underlying comorbidities (hypertension, diabetes, cardiovascular diseases, chronic obstructive pulmonary disease and chronic kidney disease). Novel coronavirus pneumonia (NCP) was much more severe in the ACI patients than in patients with non-definite ACI (p<0.001). Multivariate analyses showed that C-reactive protein (CRP) levels, old age, NCP severity, and underlying comorbidities were the risk factors for cardiac abnormalities in COVID-19 patients. Conclusions Cardiac involvements are common in COVID-19 patients. Elevated CRP levels, old age, underlying comorbidities, and NCP severity are the main risk factors for cardiac involvement in COVID-19 patients. More attention should be given to cardiovascular protection during COVID-19 treatment for mortality reduction.
Keywords: COVID‐19; Cardiac involvement; acute cardiac injury; risk factor.