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Characterization of Myocardial Injury in Patients With COVID-19
Gennaro Giustino1, Lori B Croft1, Giulio G Stefanini2
1The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.
Journal of the American College of Cardiology
|October 30, 2020
Summary
Myocardial injury is common in COVID-19 patients and linked to poor outcomes. Echocardiographic abnormalities in these patients significantly increase in-hospital mortality risk.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Myocardial injury is frequent in coronavirus disease-2019 (COVID-19) patients, correlating with poor prognosis.
- Mechanisms of COVID-19-related myocardial injury and associated cardiovascular imaging findings require further elucidation.
Purpose of the Study:
- To characterize echocardiographic abnormalities in COVID-19 patients with myocardial injury.
- To assess the prognostic impact of these echocardiographic findings on in-hospital mortality.
Main Methods:
- International, multicenter cohort study of 305 hospitalized COVID-19 patients.
- Transthoracic echocardiography (TTE) and electrocardiography were performed.
- Myocardial injury defined by elevated cardiac troponin.
Main Results:
- Myocardial injury occurred in 62.3% of patients.
- Patients with myocardial injury showed more ECG abnormalities, higher inflammatory markers, and increased echocardiographic abnormalities.
- In-hospital mortality rates were 5.2% (no injury), 18.6% (injury, no TTE abnormalities), and 31.7% (injury with TTE abnormalities).
Conclusions:
- Cardiac structural abnormalities were found in nearly two-thirds of COVID-19 patients with myocardial injury.
- Myocardial injury with echocardiographic abnormalities significantly increased in-hospital mortality risk.
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