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Published on: June 12, 2021
Cardiovascular complications and its impact on outcomes in COVID-19
Shekhar Kunal1, Shashi Mohan Sharma1, Sohan Kumar Sharma1
1Department of Cardiology, SMS Medical College, Jaipur, Rajasthan, India.
Insights
Cardiovascular complications, including acute cardiac injury, are frequent in COVID-19 patients and significantly increase mortality risk. Early identification of these issues is crucial for improving patient outcomes in coronavirus disease 2019.
Area of Science:
- Cardiology
- Infectious Diseases
- Internal Medicine
Background:
- Coronavirus disease 2019 (COVID-19) has caused significant global morbidity and mortality.
- The involvement of the cardiovascular system in COVID-19 patients is not fully understood.
- Limited data exists on cardiovascular complications and their impact on outcomes in COVID-19.
Purpose of the Study:
- To evaluate the frequency and types of cardiovascular (CV) complications in symptomatic COVID-19 patients.
- To assess the impact of these CV complications on patient outcomes, including mortality.
- To identify predictors of mortality in COVID-19 patients with CV involvement.
Main Methods:
- A single-center observational study was conducted on symptomatic COVID-19 patients.
- Data collected included clinical profiles, laboratory results, CV complications, treatments, and outcomes.
- Cardiac biomarkers, electrocardiograms (ECG), and echocardiography (when indicated) were utilized. Corrected QT-interval (QTc) was computed.
Main Results:
- Of 108 patients, 25.9% experienced acute cardiac injury, 3.7% had heart failure, cardiogenic shock, or acute coronary syndrome, and 2.8% had probable myocarditis.
- QTc prolongation was observed in 17.6% of subjects. Patients with acute cardiac injury had significantly higher mortality (57.1%) compared to those without (17.5%).
- Independent predictors of mortality included acute cardiac injury, lymphopenia, use of inotropic agents, and neutrophil-lymphocyte ratio.
Conclusions:
- Cardiovascular complications, particularly acute cardiac injury, are common in COVID-19 patients.
- The presence of acute cardiac injury is strongly associated with a worse prognosis and increased mortality.
- These findings highlight the importance of monitoring cardiovascular health in COVID-19 patients.
Background:
Coronavirus disease 2019 (COVID-19) has led to a widespread morbidity and mortality. Limited data exists regarding the involvement of cardiovascular system in COVID-19 patients. We sought to evaluate the cardiovascular (CV) complications and its impact on outcomes in symptomatic COVID-19 patients.
Methods:
This was a single center observational study among symptomatic COVID-19 patients. Data regarding clinical profile, laboratory investigations, CV complications, treatment and outcomes were collected. Cardiac biomarkers and 12 lead electrocardiograms were done in all while echocardiography was done in those with clinical indications for the same. Corrected QT-interval (QTc) at baseline and maximum value during hospitalization were computed.
Results:
Of the 108 patients, majority of them were males with a mean age of 51.2 ± 17.7 years. Hypertension (38%) and diabetes (32.4%) were most prevalent co-morbidities. ECG findings included sinus tachycardia in 18 (16.9%), first degree AV block in 5 (4.6%), VT/VF in 2 (1.8%) and sinus bradycardia in one (0.9%). QTc prolongation was observed in 17.6% subjects. CV complications included acute cardiac injury in 25.9%, heart failure, cardiogenic shock and acute coronary syndrome in 3.7% each, "probable" myocarditis in 2.8% patients. Patients with acute cardiac injury had higher mortality than those without (16/28 [57.1%] vs 14/78 [17.5%]; P < 0.0001). Multivariate logistic regression analysis showed that acute cardiac injury (OR: 11.3), lymphopenia (OR: 4.91), use of inotropic agents (OR: 2.46) and neutrophil-lymphocyte ratio (OR:1.1) were independent predictors of mortality.
Conclusions:
CV complications such as acute cardiac injury is common in COVID-19 patients and is associated with worse prognosis.
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