Myocardial injury in hospitalized patients with COVID-19 infection-Risk factors and outcomes

• Published in: PloS one 2021-02, Vol.16 (2), p.e0247800-e0247800
• Main Authors: Efros, Orly, Barda, Noam, Meisel, Eshcar, Leibowitz, Avshalom, Fardman, Alexander, Rahav, Galia, Klempfner, Robert, Grossman, Ehud
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Angiotensin; Angiotensin II; Beta blockers; Biology and Life Sciences; Blood Pressure; Body temperature; Cardiomyopathy; Cardiovascular disease; Cardiovascular diseases; Complications; Congestive heart failure; Coronary artery disease; Coronaviruses; COVID-19; COVID-19 - blood; COVID-19 - complications; COVID-19 - diagnosis; Creatinine; Demographic aspects; Diabetes; Diabetes mellitus; Editing; Electrocardiography; Female; Fibrillation; Global health; Health care facilities; Health risks; Heart diseases; Heart Diseases - blood; Heart Diseases - complications; Heart Diseases - diagnosis; Heart failure; Hospitalization; Hospitals; Humans; Hydroxymethylglutaryl-CoA reductase; Hypertension; Infections; Injuries; Ischemia; Kidney diseases; Kidneys; Laboratories; Laboratory tests; Male; Medical records; Medicine; Medicine and Health Sciences; Mercury; Middle Aged; Mortality; Myocardium - pathology; Oxygen; Oxygen content; Oxygen saturation; Pandemics; Patient outcomes; Patients; Peptidyl-dipeptidase A; Pneumonia; Prognosis; Public health; Reductases; Regression analysis; Research and Analysis Methods; Respiratory distress syndrome; Retrospective Studies; Risk analysis; Risk factors; SARS-CoV-2 - isolation & purification; Severe acute respiratory syndrome coronavirus 2; Troponin - analysis; Viral diseases
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0247800

Myocardial injury in hospitalized patients is associated with poor prognosis. This study aimed to evaluate risk factors for myocardial injury in hospitalized patients with coronavirus disease 2019 (COVID-19) and its prognostic value. We retrieved all consecutive patients who were hospitalized in internal medicine departments in a tertiary medical center from February 9th, 2020 to August 28th with a diagnosis of COVID-19. A total of 559 adult patients were hospitalized in the Sheba Medical Center with a diagnosis of COVID-19, 320 (57.24%) of whom were tested for troponin levels within 24-hours of admission, and 91 (28.44%) had elevated levels. Predictors for elevated troponin levels were age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01-1.06), female sex (OR, 3.03; 95% CI 1.54-6.25), low systolic blood pressure (OR, 5.91; 95% CI 2.42-14.44) and increased creatinine level (OR, 2.88; 95% CI 1.44-5.73). The risk for death (hazard ratio [HR] 4.32, 95% CI 2.08-8.99) and a composite outcome of invasive ventilation support and death (HR 1.96, 95% CI 1.15-3.37) was significantly higher among patients who had elevated troponin levels. In conclusion, in hospitalized patients with COVID-19, elevated troponin levels are associated with poor prognosis. Hence, troponin levels may be used as an additional tool for risk stratification and a decision guide in patients hospitalized with COVID-19.