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Cardiac damage in patients with the severe type of coronavirus disease 2019 (COVID-19)
Jing Li1, Yinghua Zhang2, Fang Wang3
1Division of Cardiology, Beijing Hospital, #1 Dahua Road, Dongcheng District, Beijing, 100730, China. leejingabc@sina.com.
Insights
Severe COVID-19 patients experienced cardiac damage, particularly males with hypertension. This highlights the need for increased clinical attention to heart health during the pandemic.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19) is a global pandemic affecting multiple organs beyond the lungs.
- Cardiac complications are increasingly recognized as a significant concern in COVID-19 patients.
Purpose of the Study:
- To investigate the prevalence and risk factors of cardiac damage in severe COVID-19 cases.
- To identify specific patient subgroups at higher risk for cardiac involvement.
Main Methods:
- Data from 100 severe COVID-19 patients were analyzed, including demographics, medical history, and laboratory tests.
- Cardiac damage was defined using elevated plasma hypersensitive troponin I (hsTnI) and/or N-terminal-pro brain natriuretic peptide (NTproBNP) levels, with age-adjusted thresholds.
- In-hospital mortality was observed and analyzed in relation to cardiac damage.
Main Results:
- Cardiac damage was present in 25% of severe COVID-19 patients.
- Elevated hsTnI levels were significantly higher in older patients (≥60 years) and males.
- Male sex and hypertension were identified as independent risk factors for cardiac damage after multivariable analysis.
Conclusions:
- Cardiac damage is a notable complication in severe COVID-19, especially in males with hypertension.
- These findings underscore the importance of vigilant cardiac monitoring for COVID-19 patients, particularly those with pre-existing cardiovascular risk factors.
- Early identification and management of cardiac damage are crucial for improving outcomes in severe COVID-19.
Background:
Coronavirus disease 2019 (COVID-19) has become a global pandemic. Studies showed COVID-19 affected not only the lung but also other organs. In this study, we aimed to explore the cardiac damage in patients with COVID-19.
Methods:
We collected data of 100 patients diagnosed as severe type of COVID-19 from February 8 to April 10, 2020, including demographics, illness history, physical examination, laboratory test, and treatment. In-hospital mortality were observed. Cardiac damage was defined as plasma hypersensitive troponin I (hsTnI) over 34.2 pg/ml and/or N-terminal-pro brain natriuretic peptide (NTproBNP) above 450 pg/ml at the age < 50, above 900 pg/ml at the age < 75, or above 1800 pg/ml at the age ≥ 75.
Results:
The median age of the patients was 62.0 years old. 69 (69.0%) had comorbidities, mainly presenting hypertension, diabetes, and cardiovascular disease. Fever (69 [69.0%]), cough (63 [63.0%]), chest distress (13 [13.0%]), and fatigue (12 [12.0%]) were the common initial symptoms. Cardiac damage occurred in 25 patients. In the subgroups, hsTnI was significantly higher in elder patients (≥ 60 years) than in the young (median [IQR], 5.2 [2.2-12.8] vs. 1.9 [1.9-6.2], p = 0.018) and was higher in men than in women (4.2 [1.9-12.8] vs. 2.9 [1.9-7.4], p = 0.018). The prevalence of increased NTproBNP was significantly higher in men than in women (32.1% vs. 9.1%, p = 0.006), but was similar between the elder and young patients (20.0% vs. 25.0%, p = 0.554). After multivariable analysis, male and hypertension were the risk factors of cardiac damage. The mortality was 4.0%.
Conclusions:
Cardiac damage exists in patients with the severe type of COVID-19, especially in male patients with hypertension. Clinicians should pay more attention to cardiac damage.
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