The prognostic value of myocardial injury in COVID‐19 patients and associated characteristics
Abstract Background Since December 2019, coronavirus disease 2019 (COVID‐19) has emerged as an international pandemic. COVID‐19 patients with myocardial injury might need special attention. However, an understanding on this aspect remains unclear. This study aimed to illustrate clinical characterist...
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| Format: | Article |
| Language: | English |
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Wiley
2021-12-01
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| Series: | Immunity, Inflammation and Disease |
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| Online Access: | https://doi.org/10.1002/iid3.484 |
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| author | Jian He Bicheng Zhang Quan Zhou Wenjing Yang Jing Xu Tingting Liu Haijun Zhang Zhiyong Wu Dong Li Qing Zhou Jie Yan Cuizhen Zhang Haiyan Qian Minjie Lu Xiaoyang Zhou |
| author_facet | Jian He Bicheng Zhang Quan Zhou Wenjing Yang Jing Xu Tingting Liu Haijun Zhang Zhiyong Wu Dong Li Qing Zhou Jie Yan Cuizhen Zhang Haiyan Qian Minjie Lu Xiaoyang Zhou |
| author_sort | Jian He |
| collection | DOAJ |
| description | Abstract Background Since December 2019, coronavirus disease 2019 (COVID‐19) has emerged as an international pandemic. COVID‐19 patients with myocardial injury might need special attention. However, an understanding on this aspect remains unclear. This study aimed to illustrate clinical characteristics and the prognostic value of myocardial injury to COVID‐19 patients. Methods This retrospective, single‐center study finally included 304 hospitalized COVID‐19 cases confirmed by real‐time reverse‐transcriptase polymerase chain reaction from January 11 to March 25, 2020. Myocardial injury was determined by serum high‐sensitivity troponin I (Hs‐TnI). The primary endpoint was COVID‐19‐associated mortality. Results Of 304 COVID‐19 patients (median age, 65 years; 52.6% males), 88 patients (27.3%) died (61 patients with myocardial injury, 27 patients without myocardial injury on admission). COVID‐19 patients with myocardial injury had more comorbidities (hypertension, chronic obstructive pulmonary disease, cardiovascular disease, and cerebrovascular disease); lower lymphocyte counts, higher C‐reactive protein (CRP; median, 84.9 vs. 28.5 mg/L; p < .001), procalcitonin levels (median, 0.29 vs. 0.06 ng/ml; p < .001), inflammatory and immune response markers; more frequent need for noninvasive ventilation, invasive mechanical ventilation; and was associated with higher mortality incidence (hazard ratio [HR] = 7.02; 95% confidence interval [CI], 4.45–11.08; p < .001) than those without myocardial injury. Myocardial injury (HR = 4.55; 95% CI, 2.49–8.31; p < .001), senior age, CRP levels, and novel coronavirus pneumonia types on admission were independent predictors to mortality in COVID‐19 patients. Conclusions COVID‐19 patients with myocardial injury on admission is associated with more severe clinical presentation and biomarkers. Myocardial injury and higher Hs‐TnI are both strongest independent predictors to COVID‐19‐related mortality after adjusting confounding factors. |
| format | Article |
| id | doaj-art-df9b3125a0114ba6b68d56a0bcdc41a3 |
| institution | Matheson Library |
| issn | 2050-4527 |
| language | English |
| publishDate | 2021-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Immunity, Inflammation and Disease |
| spelling | doaj-art-df9b3125a0114ba6b68d56a0bcdc41a32025-07-31T06:17:37ZengWileyImmunity, Inflammation and Disease2050-45272021-12-01941358136910.1002/iid3.484The prognostic value of myocardial injury in COVID‐19 patients and associated characteristicsJian He0Bicheng Zhang1Quan Zhou2Wenjing Yang3Jing Xu4Tingting Liu5Haijun Zhang6Zhiyong Wu7Dong Li8Qing Zhou9Jie Yan10Cuizhen Zhang11Haiyan Qian12Minjie Lu13Xiaoyang Zhou14State Key Laboratory of Cardiovascular Disease, Department of Magnetic Resonance Imaging, National Center for Cardiovascular Diseases Fuwai Hospital Beijing ChinaCancer Center Renmin Hospital of Wuhan University Wuhan ChinaDepartment of Clinical Laboratory Renmin Hospital of Wuhan University Wuhan ChinaState Key Laboratory of Cardiovascular Disease, Department of Magnetic Resonance Imaging, National Center for Cardiovascular Diseases Fuwai Hospital Beijing ChinaState Key Laboratory of Cardiovascular Disease, Department of Magnetic Resonance Imaging, National Center for Cardiovascular Diseases Fuwai Hospital Beijing ChinaDepartment of Cardiology Renmin Hospital of Wuhan University Wuhan ChinaDepartment of Cardiology Renmin Hospital of Wuhan University Wuhan ChinaDepartment of Cardiovascular Surgery Renmin Hospital of Wuhan University Wuhan ChinaDepartment of Clinical Laboratory Renmin Hospital of Wuhan University Wuhan ChinaDepartment of Ultrasound Imaging Renmin Hospital of Wuhan University Wuhan ChinaDepartment of Cardiology Renmin Hospital of Wuhan University Wuhan ChinaDepartment of Cardiology Renmin Hospital of Wuhan University Wuhan ChinaState Key Laboratory of Cardiovascular Disease, Department of Magnetic Resonance Imaging, National Center for Cardiovascular Diseases Fuwai Hospital Beijing ChinaState Key Laboratory of Cardiovascular Disease, Department of Magnetic Resonance Imaging, National Center for Cardiovascular Diseases Fuwai Hospital Beijing ChinaDepartment of Cardiology Renmin Hospital of Wuhan University Wuhan ChinaAbstract Background Since December 2019, coronavirus disease 2019 (COVID‐19) has emerged as an international pandemic. COVID‐19 patients with myocardial injury might need special attention. However, an understanding on this aspect remains unclear. This study aimed to illustrate clinical characteristics and the prognostic value of myocardial injury to COVID‐19 patients. Methods This retrospective, single‐center study finally included 304 hospitalized COVID‐19 cases confirmed by real‐time reverse‐transcriptase polymerase chain reaction from January 11 to March 25, 2020. Myocardial injury was determined by serum high‐sensitivity troponin I (Hs‐TnI). The primary endpoint was COVID‐19‐associated mortality. Results Of 304 COVID‐19 patients (median age, 65 years; 52.6% males), 88 patients (27.3%) died (61 patients with myocardial injury, 27 patients without myocardial injury on admission). COVID‐19 patients with myocardial injury had more comorbidities (hypertension, chronic obstructive pulmonary disease, cardiovascular disease, and cerebrovascular disease); lower lymphocyte counts, higher C‐reactive protein (CRP; median, 84.9 vs. 28.5 mg/L; p < .001), procalcitonin levels (median, 0.29 vs. 0.06 ng/ml; p < .001), inflammatory and immune response markers; more frequent need for noninvasive ventilation, invasive mechanical ventilation; and was associated with higher mortality incidence (hazard ratio [HR] = 7.02; 95% confidence interval [CI], 4.45–11.08; p < .001) than those without myocardial injury. Myocardial injury (HR = 4.55; 95% CI, 2.49–8.31; p < .001), senior age, CRP levels, and novel coronavirus pneumonia types on admission were independent predictors to mortality in COVID‐19 patients. Conclusions COVID‐19 patients with myocardial injury on admission is associated with more severe clinical presentation and biomarkers. Myocardial injury and higher Hs‐TnI are both strongest independent predictors to COVID‐19‐related mortality after adjusting confounding factors.https://doi.org/10.1002/iid3.484clinical characteristicscoronavirus disease 2019myocardial injuryprognosis |
| spellingShingle | Jian He Bicheng Zhang Quan Zhou Wenjing Yang Jing Xu Tingting Liu Haijun Zhang Zhiyong Wu Dong Li Qing Zhou Jie Yan Cuizhen Zhang Haiyan Qian Minjie Lu Xiaoyang Zhou The prognostic value of myocardial injury in COVID‐19 patients and associated characteristics Immunity, Inflammation and Disease clinical characteristics coronavirus disease 2019 myocardial injury prognosis |
| title | The prognostic value of myocardial injury in COVID‐19 patients and associated characteristics |
| title_full | The prognostic value of myocardial injury in COVID‐19 patients and associated characteristics |
| title_fullStr | The prognostic value of myocardial injury in COVID‐19 patients and associated characteristics |
| title_full_unstemmed | The prognostic value of myocardial injury in COVID‐19 patients and associated characteristics |
| title_short | The prognostic value of myocardial injury in COVID‐19 patients and associated characteristics |
| title_sort | prognostic value of myocardial injury in covid 19 patients and associated characteristics |
| topic | clinical characteristics coronavirus disease 2019 myocardial injury prognosis |
| url | https://doi.org/10.1002/iid3.484 |
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