TY - JOUR
AU - Briscoe, Michael
AU - Sykes, R.
AU - Krystofiak, T.
AU - Peck, O.
AU - Mangion, Kenneth
AU - Berry, Colin
PY - 2021
DA - January
TI - Clinical significance of coronavirus disease 2019 in hospitalized patients with myocardial injury
JO - Clinical Cardiology
EP - 339
VL - 44
DO - http://dx.doi.org/10.1002/clc.23530
AB - Background: The clinical significance of Coronavirus disease 2019 (COVID‐19) as an associate of myocardial injury is controversial. Hypothesis: Type 2 MI/Myocardial Injury are associated with worse outcomes if complicated by COVID‐19. Methods: This longitudinal cohort study involved consecutive patients admitted to a large urban hospital. Myocardial injury was determined using laboratory records as ≥1 hs‐TnI result &gt;99th percentile (male: &gt;34 ng/L; female: &gt;16 ng/L). Endotypes were defined according to the Fourth Universal Definition of Myocardial Infarction (MI) and COVID‐19 determined using PCR. Outcomes of patients with myocardial injury with and without COVID‐19 were assessed. Results: Of 346 hospitalized patients with elevated hs‐TnI, 35 (10.1%) had laboratory‐confirmed COVID‐19 (median age [IQR]; 65 [59–74]; 64.8% male vs. COVID‐19 negative: 74 [63–83] years; 43.7% male). Cardiac endotypes by COVID‐19 status (yes vs. no) were: Type 1 MI (0 [0%] vs. 115 [100%]; p &lt; .0005), Type 2 MI (13 [16.5%] vs. 66 [83.5%]; p = .045), and non‐ischemic myocardial injury (cardiac: 4 [5.8%] vs. 65 [94.2%]; p = .191, non‐cardiac:19 [22.9%] vs. 64 [77.%]; p &lt; .0005). COVID‐19 patients had less comorbidity (median [IQR] Charlson Comorbidity Index: 3.0 [3.0] vs. 5.0 [4.0]; p = .001), similar hs‐TnI concentrations (median [IQR] initial: 46 [113] vs. 62 [138]; p = .199, peak: 122 [474] vs. 79 [220] ng/L; p = .564), longer admission (days) (median [IQR]: 14[19] vs. 6[12]; p = .001) and higher in‐hospital mortality (63.9% vs. 11.3%; OR = 13.2; 95%CI: 5.90, 29.7). Conclusions: Cardiac sequelae of COVID‐19 typically manifest as Non‐cardiac myocardial injury/Type 2MI in younger patients with less co‐morbidity. Paradoxically, the admission duration and in‐hospital mortality are increased.
PB - Wiley
UR - http://eprints.gla.ac.uk/222837/
KW - Coronavirus (COVID-19)
KW - Hospital care
ER