Prevalence and impact of myocardial injury among patients hospitalized with COVID-19

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Khoi Minh Le¹  Dan Ngoc Pham²  Vu Hoang Vu³  Quang Dang Duy Pham⁴  Thanh Cong Nguyen⁴  Le Bao Le⁵ 

[1] Cardiac Imaging Unit, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam;Department of Cardiology, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam;Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam;Interventional Cardiology Department, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam;Interventional Cardiology Department, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam;Rheumatology Department, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam;

关键词: COVID-19;    SARS-CoV-2;    myocardial injury;    cardiac injury;    troponin;    prognosis;   

DOI  :  10.3389/fcvm.2023.1202332

 received in 2023-04-08, accepted in 2023-07-18,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundMyocardial injury is a prevalent complication observed in patients hospitalized with COVID-19 and is strongly associated with severe illness and in-hospital mortality. However, the long-term consequences of myocardial injury on clinical outcomes remain poorly understood. This study aimed to assess the impact of myocardial injury on both acute-phase and long-term prognosis in COVID-19 patients.MethodsA retrospective, observational study was conducted on all patients who received treatment at the Intensive Care Center for COVID-19 patient, University Medical Center Ho Chi Minh City (UCICC), from August 3rd, 2021, to October 28th, 2021.ResultsA total of 582 patients were enrolled in the study, of which 55.3% were female. The mean age of participants was 63.3 ± 16.2. Out of these patients, 330 cases (56.8%) showed myocardial injury. Compared to patients without myocardial injury, those with myocardial injury were older and had a higher incidence of chronic diseases including hypertension, ischemic heart disease, atrial fibrillation, heart failure, diabetes mellitus, chronic kidney disease. They also presented with more severe respiratory failure upon admission and showed a more pronounced abnormality in inflammation and kidney function tests. Furthermore, the in-hospital mortality rate was significantly higher in the group with myocardial injury (49.7% vs 14.3%, p < 0.001). After adjusting for age, gender, comorbidities, renal function, and disease severity at admission, myocardial injury emerged as an independent risk factor for in-hospital mortality (OR = 3.758, 95% CI 1.854–7.678, p < 0.001). Among successfully discharged COVID-19 patients, the all-cause mortality rate after a median follow-up of 18.4 months was 7.9%. Patients with myocardial injury had a significantly higher long-term mortality rate compared to those without myocardial injury (14.0% vs. 3.2%, p < 0.001). However, multivariable Cox regression analysis did not find myocardial injury to be a significant predictor of long-term mortality (HR = 2.128, 95% CI 0.792–5.712, p = 0.134).ConclusionsMyocardial injury is a common and serious complication in hospitalized COVID-19 patients, associated with increased in-hospital mortality. However, it does not significantly impact long-term mortality in successfully discharged COVID-19 patients.

【 授权许可】

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© 2023 Vu, Nguyen, Pham, Pham, Le and Le.