No abstract

This study aimed to determine if cardiac troponin I (cTnI) is an independent predictor of clinical outcomes and whether higher values are associated with worse clinical outcomes in Covid-19 patients. This case-series study was conducted at Phoebe Putney Health System. Participants were confirmed Covid-19 patients admitted to our health system between March 2, 2020 and June 7, 2020. Data were collected from electronic medical records. Patients were divided into 2 groups: with and without elevated cTnI. The cTnI were further divided in 4 tertiles. Multivariable logistic regression analysis was performed to adjust for demographics, baseline comorbidities, and laboratory parameters including D-dimer, ferritin, lactate dehydrogenase, procalcitonin and C-reactive protein. Out of 309 patients, 116 (37.5%) had elevated cTnI. Those with elevated cTnI were older (59.9 vs. 68.2 years, p <0.001), and more likely to be males (53.5% vs. 36.3%, p = 0.003). Elevated cTnI group had higher baseline comorbidities. After multivariable adjustment, overall mortality was significantly higher in elevated cTnI group (37.9% vs. 11.4%, odds ratio:4.45; confidence interval:1.78 to 11.14, p <0.001). Need for intubation, dialysis, and intensive care unit (ICU) transfer was higher in elevated cTnI group. Among those with elevated cTnI, mortality was 23.2% for 50th percentile, 48.4% for 75th percentile, and 55.2% for 100th percentile. Similarly, further increase in cTnI was associated with a higher need for intubation, dialysis, and ICU transfer. In conclusion, myocardial injury occurs in significant proportion of hospitalized Covid-19 patients and is an independent predictor of clinical outcomes, with higher values associated with worse outcomes.

Multibeam bathymetry, deep‐towed side scan sonar, gravity, and magnetic data over a 50 km square area all suggest the presence of a second‐order, nontransform offset on the obliquely spreading Reykjanes Ridge (North Atlantic ocean) near 58°N latitude. It is the first such offset to be recognized on the Reykjanes Ridge. This region is characterized by a shallow median valley containing en echelon axial volcanic ridges (AVRs) similar to those found on more northerly parts of the Reykjanes Ridge. The side scan sonar shows that all the AVRs are constructional in nature. The one immediately south of the offset basin backscatters strongly, is unmarked by faulting, and so appears extremely young. Other AVRs appear older, having lower backscatter and, off axis, being cut by faults and fissures. At 57°55′N the progression of AVRs is interrupted by a 600‐m‐deep, 20 km × 10 km basin. Residual mantle Bouguer anomalies, corrected for two‐dimensional lithospheric cooling, display a high of at least 8 mGal over the basin. Two small, off axis basins occur roughly along the flow line from this basin and are also characterized by gravity highs. The basins are interpreted as regions of crustal thinning and are believed to represent the discontinuous trace of the ridge offset, which has thus been in existence for at least 2 m.y. and has been slowly propagating south. Inversion of the magnetic field shows a very low magnetization (∼3–4 A m−1) associated with the offset basin, which is interpreted as indicating a reduced magnetic layer thickness due to poor magma supply to the offset area. The Brunhes‐Matuyama reversal boundary and Anomaly 2 traces are offset about 3 km dextrally across the proposed offset trace. The AVR immediately north of the offset displays high amplitudes of magnetization which steadily increase southward toward its tip adjacent to the offset, suggesting the presence of increasingly highly fractionated basalts toward the AVR tip. Polarity transition widths across the Brunhes‐Matuyama boundary are comparable with those on other slow spreading ridges but are wider than individual AVRs, probably because AVRs overlap in the crustal accretion zone. Transition widths are also asymmetrical across the spreading center, being narrower (∼4.5 km) to the east than the west (∼8 km), suggesting a certain degree of asymmetry in the accretionary and rifting processes at the ridge axis.

Mean gravity profiles have been obtained from gravity fields constructed using Geosat Geodetic Mission altimeter data for a number of areas over mid‐ocean ridges. The technique of averaging many profiles reduces the effects of along‐axis variability and allows systematic changes as a function of spreading rate to be seen more clearly. For spreading rates larger than about 60–65 mm/yr, an axial gravity high is observed with an almost constant amplitude (∼12 mgal) that narrows as the spreading rate increases. For spreading rates lower than this, an axial gravity low is observed whose amplitude decreases rapidly with spreading rate while the width reduces only slowly. The disappearance of a median valley occurs abruptly on any one ridge, but occurs at slightly different spreading rates on the Southeast Indian Ridge (68 mm/yr) and the Pacific‐Antarctic Ridge (60 mm/yr). These observations are compared with the predictions of current models of mid‐ocean ridge processes but are not fully explained by them.