Patients with SARS-CoV-2 Omicron variant infection complicated with myocardial injury: a retrospective cohort study

The SARS-CoV-2 virus and its variants affect not only the respiratory system but also the heart. The impact of SARS-CoV-2 on the heart during the Omicron pandemic is not yet fully elucidated.

We conducted a retrospective cohort study of 1,026 hospitalized patients with the Omicron variant at Southwest Hospital (December 2022 to March 2023). Adverse events were defined as a composite of all-cause mortality, intensive care unit admission, mechanical ventilation use, and discharge against medical advice. The risk factors were analyzed by Logistic regression and the Cox regression model.

Median age was 69 years (IQR 56-79), myocardial injury occurred in 54.7% (n = 561); adverse events occurred in 25.5% (n = 262). The risk factors of myocardial injury included older age (OR 1.04 [1.03, 1.05], p < 0.001), body temperature at admission (OR 1.64 [1.19, 2.29], p = 0.003), critical COVID-19 (OR 4.96 [2.34, 11.54], p < 0.001), severe valvular heart disease (OR 2.46 [1.06, 6.12], p = 0.042), renal insufficiency (OR 4.04 [2.75, 6.01], p < 0.001), anemia (OR 3.10 [2.12, 4.58], p < 0.001), type II respiratory failure (OR 5.54 [1.79, 24.39], p = 0.008) and higher white blood cell (OR 1.09 [1.05, 1.14], p < 0.001). After adjustment, myocardial injury (HR 1.79 [1.28, 2.48], p = 0.001) was significantly associated with adverse events in patients with Omicron variant infection.

Myocardial injury, the most common extrapulmonary complication of COVID-19 caused by the SARS-CoV-2 Omicron variant, requires timely attention to prevent adverse events in hospitalized patients.