Impact of complicated myocardial injury on the clinical outcome of severe or critically ill COVID-19 patients.
10.3760/cma.j.cn112148-20200228-00137
- VernacularTitle:重型/危重型新型冠状病毒肺炎患者合并心肌损伤对预后的影响
- Author:
Xing Wei HE
1
;
Jin Sheng LAI
1
;
Jia CHENG
1
;
Meng Wen WANG
1
;
Yu Jian LIU
1
;
Zhi Chao XIAO
1
;
Chang XU
1
;
Shu Sheng LI
2
;
He Song ZENG
1
Author Information
1. Department of Cardiology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
2. Department of Emergency,Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
- Publication Type:Journal Article
- Keywords:
COVID-19;
Myocardial injury;
Troponin
- MeSH:
Aged;
Betacoronavirus;
COVID-19;
Coronavirus Infections/complications*;
Critical Illness;
Heart Injuries;
Humans;
Middle Aged;
Pandemics;
Pneumonia, Viral/complications*;
Retrospective Studies;
SARS-CoV-2
- From:
Chinese Journal of Cardiology
2020;48(6):456-460
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To analyze the clinical characteristics of the severe or critically ill patients with novel coronavirus pneumonia (COVID-19), and evaluate the impact of complicated myocardial injury on the prognosis of these patients. Methods: A retrospective study was conducted in 54 patients who admitted to Tongji hospital from February 3, 2020 to February 24, 2020 and met the criteria of severe or critical conditions of COVID-19. The clinical characteristics and hospital mortality rate were analyzed and compared between the patients with or without myocardial injury, which was defined with 3 times higher serum cardiac troponin value. Results: The age of the 54 patients was 68.0(59.8, 74.3) years. Among all the patients, 24 (44.4%) patients were complicated with hypertension, 13 (24.1%) with diabetes, 8 (14.8%) with coronary heart disease, and 3 (5.6%) with previous cerebral infarction. During hospitalization, 24 (44.4%) of the patients were complicated with myocardial injury and 26 (48.1%) patients died in hospital. In-hospital mortality was significantly higher in patients with myocardial injury than in patients without myocardial injury (14 (60.9%) vs. 8 (25.8%), P=0.013). Moreover, the levels of C-reactive protein (153.6 (80.3, 240.7) ng/L vs. 49.8 (15.9, 101.9) ng/L) and N-terminal pro-B-type natriuretic peptide (852.0 (400.0, 2 315.3) ng/L vs. 197.0 (115.3, 631.0) ng/L) were significantly higher than patients without myocardial injury (all P<0.01). Conclusions: Prevalence of myocardial injury is high among severe or critically ill COVID-19 patients. Severe or critically ill COVID-19 patients with myocardial injury face a significantly higher risk of in-hospital mortality. The study suggests that it is important to monitor and manage the myocardial injury during hospitalization for severe or critically ill COVID-19 patients.
