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Cardiac manifestations of COVID-19 in Shenzhen, China

Jia-Hui Zeng1, Wei-Bo Wu2, Jiu-Xin Qu3

  • 1Department of Medical Ultrasonics, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, NO. 29 Bulan Road, Shenzhen, 518112, People's Republic of China.

Infection
|July 30, 2020
PubMed

Insights

Intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19) experienced more cardiac issues, including elevated myocardial injury markers and heart failure. These cardiac complications in COVID-19 patients appear linked to the systemic response rather than direct viral damage.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • The coronavirus disease 2019 (COVID-19) pandemic poses a significant global health challenge.
  • Detailed reports on cardiac injury associated with COVID-19 are limited.
  • Understanding cardiac manifestations is crucial for managing severe cases.

Purpose of the Study:

  • To compare the clinical and echocardiographic characteristics of intensive care unit (ICU) versus non-ICU patients with COVID-19.
  • To identify specific cardiac injuries prevalent in severe COVID-19 cases requiring ICU admission.
  • To differentiate between direct viral effects and systemic responses contributing to cardiac damage.

Main Methods:

  • A cohort of 416 COVID-19 patients was analyzed.
  • Patients were categorized into two groups: ICU (n=35) and non-ICU (n=381).
  • Comparative analysis included medical histories, laboratory findings (troponin I, myoglobin), and echocardiography data.

Main Results:

  • ICU patients exhibited significantly higher levels of myocardial injury markers (troponin I, myoglobin) compared to non-ICU patients.
  • Echocardiographic findings revealed increased prevalence of ventricular wall thickening, pulmonary hypertension, and reduced left-ventricular ejection fraction in ICU patients.
  • Cardiac complications such as acute cardiac injury (60% vs 3%), arrhythmias (9% vs 1%), and acute heart failure (14% vs 0%) were substantially more common in the ICU group.

Conclusions:

  • COVID-19 patients admitted to the ICU demonstrate a higher incidence of myocardial injury markers, ventricular wall thickening, pulmonary hypertension, and various cardiac complications.
  • The observed cardiac injury in severe COVID-19 cases may stem from the body's systemic inflammatory response to the infection rather than direct SARS-CoV-2-induced myocardial damage.
  • Further research is warranted to elucidate the precise mechanisms of cardiac involvement in COVID-19.
Abstract

Keywords:
COVID-19CoronavirusEchocardiographyIntensive-care unitMyocarditis

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