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Prevalence and Impact of Myocardial Injury in Patients Hospitalized With COVID-19 Infection
- Source :
- Journal of the American College of Cardiology
- Publication Year :
- 2020
-
Abstract
- The degree of myocardial injury, as reflected by troponin elevation, and associated outcomes among U.S. hospitalized patients with coronavirus disease-2019 (COVID-19) are unknown.The purpose of this study was to describe the degree of myocardial injury and associated outcomes in a large hospitalized cohort with laboratory-confirmed COVID-19.Patients with COVID-19 admitted to 1 of 5 Mount Sinai Health System hospitals in New York City between February 27, 2020, and April 12, 2020, with troponin-I (normal value 0.03 ng/ml) measured within 24 h of admission were included (n = 2,736). Demographics, medical histories, admission laboratory results, and outcomes were captured from the hospitals' electronic health records.The median age was 66.4 years, with 59.6% men. Cardiovascular disease (CVD), including coronary artery disease, atrial fibrillation, and heart failure, was more prevalent in patients with higher troponin concentrations, as were hypertension and diabetes. A total of 506 (18.5%) patients died during hospitalization. In all, 985 (36%) patients had elevated troponin concentrations. After adjusting for disease severity and relevant clinical factors, even small amounts of myocardial injury (e.g., troponin I0.03 to 0.09 ng/ml; n = 455; 16.6%) were significantly associated with death (adjusted hazard ratio: 1.75; 95% CI: 1.37 to 2.24; p 0.001) while greater amounts (e.g., troponin I0.09 ng/dl; n = 530; 19.4%) were significantly associated with higher risk (adjusted HR: 3.03; 95% CI: 2.42 to 3.80; p 0.001).Myocardial injury is prevalent among patients hospitalized with COVID-19; however, troponin concentrations were generally present at low levels. Patients with CVD are more likely to have myocardial injury than patients without CVD. Troponin elevation among patients hospitalized with COVID-19 is associated with higher risk of mortality.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Pneumonia, Viral
Myocardial Infarction
Comorbidity
030204 cardiovascular system & hematology
Coronary artery disease
03 medical and health sciences
Young Adult
0302 clinical medicine
Risk Factors
Internal medicine
Troponin I
medicine
Prevalence
Electronic Health Records
Humans
030212 general & internal medicine
Myocardial infarction
Pandemics
Aged
Aged, 80 and over
biology
business.industry
Incidence
Myocardium
COVID-19
Atrial fibrillation
Myocardial contusion
Middle Aged
medicine.disease
Troponin
Hospitalization
Treatment Outcome
Heart Injuries
Cardiovascular Diseases
Heart failure
biology.protein
Myocardial infarction complications
Female
New York City
business
Cardiology and Cardiovascular Medicine
Coronavirus Infections
Subjects
Details
- ISSN :
- 15583597
- Volume :
- 76
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Cardiology
- Accession number :
- edsair.doi.dedup.....8a8971fe6c2a8b30d899cd86f012fb4c