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[Mortality associated with myocardial damage by troponin I in patients with COVID 19]
Donovan Fernando Espriu-Romero1, Martha Alicia Hernández-González2, Sergio Eduardo Solorio-Meza3
1Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No.1, Servicio de Cardiología. León, Guanajuato, México.
Insights
Patients hospitalized with COVID-19 and myocardial damage showed significantly higher mortality rates. This cardiac injury, identified by troponin I, is a critical factor in COVID-19 outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Immunology
Context:
- Coronavirus disease 2019 (COVID-19) is known to affect the cardiovascular system.
- Myocardial damage, potentially due to myocarditis or ischemia, is a recognized complication.
- This damage can trigger inflammatory and autoimmune responses.
Purpose:
- To evaluate the association between myocardial damage and mortality in hospitalized COVID-19 patients.
- To utilize troponin I measurements for assessing cardiac involvement.
Summary:
- A case-control study analyzed 28 hospitalized COVID-19 patients (June-August 2020).
- 13 patients had myocardial damage (troponin I positive), while 15 did not.
- Mortality was 92.3% in patients with myocardial damage versus 20% in those without.
Impact:
- Myocardial damage is strongly associated with increased mortality in COVID-19 patients.
- Troponin I measurement is a key indicator for assessing prognosis in these patients.
- Findings highlight the importance of cardiac monitoring in COVID-19 management.
Background:
Coronavirus disease 2019 (COVID-19) can cause cardiac injury, probably associated with myocarditis and ischemia induced by the infection. Myocardial damage leads to the liberation of proinflammatory cytokines and to the activation of autoimmune adaptive mechanisms through molecular limitation.
Objective:
To assess mortality associated with myocardial damage in hospitalized patients with COVID-19 confirmed by troponin I measurement.
Material And Methods:
Case-control study nested in a cohort of patients of a third-level hospital. Descriptive statistics were used to characterize the population. Qualitative variables were expressed as proportions and ranges, quantitative variables as means and standard deviation. Fisher's exact test was used to compare mortality between patients with and without myocardial damage. A p value < 0.05 was considered significant.
Results:
From June 2020 to August 2020, 28 patients who met the selection criteria were enrolled, out of which 15 had no myocardial damage and 13 had myocardial damage assessed by serum troponin measurement. A strong association was found between mortality and the presence of myocardial damage, since mortality was 20% (3/15) among patients without myocardial damage and 92.3% (12/13) among those with myocardial damage (Fisher's exact test, p < 0.005).
Conclusion:
Mortality in patients with COVID-19 is associated with myocardial damage assessed by troponin I measurement.
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