INTRODUCTION: A vast number of COVID-19 cases have been reported worldwide since the initial outbreak in China, and the disease has since become a global pandemic. Knowledge on this predominantly respiratory illness is evolving with studies suggesting myocardial injury reflected by elevated cardiac enzymes portending to more severe disease. CT scoring indices provide visual, semi-quantitative assessment of lung involvement and have aided in determining extent of COVID-19 pneumonia but, none have been validated for prognostication. Establishing a relationship between these non-invasive diagnostic parameters could provide timely identification and proper allocation of limited medical resources to patients in need of more aggressive therapy. METHODS AND RESULTS: A total of 50 COVID-19 patients were retrospectively enrolled and their clinical parameters collected from an electronic medical database. There was a total of 31 patients with troponin I-HS with chest CT scan done and another 42 patients for NT-proBNP and chest CT. The levels of both cardiac biomarkers in patients with clinically severe COVID pneumonia were higher than those with mild and moderate disease. Rank-order analysis showed that both troponin I-HS (moderate, p=0.0003174) and NT-proBNP (moderate, p=0.006255) correlated positively with CT severity scores. Furthermore, there is a significant relationship between mortality and septic shock with both Troponin I-HS (p<0.001; p=0.002) and NT-proBNP (p=0.004; p=0.031). CONCLUSION The cardiac markers troponin I-HS and NT-proBNP increased significantly at more severe CT scores and more notably, these biomarkers predicted the development of septic shock and mortality in COVID-19 pneumonia.
COVID-19 ; NT-proBNP ; pro-brain natriuretic peptide (1-76) ; Troponin I

BACKGROUND

Atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery may lead to prolonged hospital stay and increased morbidity and mortality. Identifying people at risk may help in the management and improve the outcome of patients undergoing this procedure.

OBJECTIVES

The aims of this were to determine the incidence of AF in patients who underwent CABG surgery in ManilaMed-Medical Center Manila and whether certain factors were associated with developing AF in patients who underwent the procedure.

METHODS

This was a single-center, retrospective, cross-sectional study wherein adult patients who underwent CABG, without previous AF, were included.

RESULTS

Among patients included in the study, 29 developed AF, with an incidence of 27.62%. Patients who had AF after CABG were, on average, older (65.79 vs 59.29 years, P = 0.002); had dyslipidemia (72% vs 47%, P = 0.021), a higher average left atrial volume index (LAVI) (26.72 vs. 23.45, P = 0.038), an LAVI greater than 34 mL/m2 (24% vs 3%, P = 0.002), and an episode of previous stroke (28% vs 11%, P = 0.038); and had been taking diuretics (28% vs 9%, P = 0.027) but had a lower prevalence of having diabetes (41% vs 66%, P = 0.023).

CONCLUSION

Atrial fibrillation remains to be a frequent arrhythmia after CABG occurring in 28% of patients who had CABG. It may occur in older patients, patients with dyslipidemia, patients with a large left atrium, patients who had a previous stroke, and patients taking diuretics. On the other hand, the odds of a diabetic patient developing AF after CABG are low.

COVID-19 ; NT-proBNP ; pro-brain natriuretic peptide (1-76) ; Troponin I