Association of coagulation dysfunction with cardiac injury among hospitalized patients with COVID-19

Liang, Chen; Hu, Wei; Guo, Xiaoxiao; Zhao, Ping; Tang, Jia; Gu, Yuwei; Huang, Ninghao; Wang, Chao; Cui, An; Zhang, Dian; Hu, Linjie; Feng, Yi; Hu, Shengshou; Chen, Mingquan; Duru, Fırat; Xiong, Chenglong

doi:10.1038/s41598-021-83822-9

Cited by 10 publications

(17 citation statements)

References 44 publications

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“…26 Another possible mechanism is the direct invasion via angiotensin converting enzyme 2 (ACE2) receptors in cardiovascular system. 3,27 In our study, we not only found that COVID-19 patients with comorbidities were associated with higher mortality, but also the CRP levels are significantly associated with mortality in multivariate Cox analysis, which indicated there would be inflammation response and this was associated with worse outcomes. In addition, IL-6 cytokines were elevated in COVID-19 patients with myocardial injury, justifying the emergence of severity of inflammation, also immune-related markers, like CD3, CD4, CD8 molecules counts and lymphocyte counts were all reduced, more significant in patients with myocardial injury.…”

Section: Discussionmentioning

confidence: 49%

The prognostic value of myocardial injury in COVID‐19 patients and associated characteristics

Zhang

Zhou

et al. 2021

Immunity Inflam & Disease

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Background Since December 2019, coronavirus disease 2019 (COVID‐19) has emerged as an international pandemic. COVID‐19 patients with myocardial injury might need special attention. However, an understanding on this aspect remains unclear. This study aimed to illustrate clinical characteristics and the prognostic value of myocardial injury to COVID‐19 patients. Methods This retrospective, single‐center study finally included 304 hospitalized COVID‐19 cases confirmed by real‐time reverse‐transcriptase polymerase chain reaction from January 11 to March 25, 2020. Myocardial injury was determined by serum high‐sensitivity troponin I (Hs‐TnI). The primary endpoint was COVID‐19‐associated mortality. Results Of 304 COVID‐19 patients (median age, 65 years; 52.6% males), 88 patients (27.3%) died (61 patients with myocardial injury, 27 patients without myocardial injury on admission). COVID‐19 patients with myocardial injury had more comorbidities (hypertension, chronic obstructive pulmonary disease, cardiovascular disease, and cerebrovascular disease); lower lymphocyte counts, higher C‐reactive protein (CRP; median, 84.9 vs. 28.5 mg/L; p < .001), procalcitonin levels (median, 0.29 vs. 0.06 ng/ml; p < .001), inflammatory and immune response markers; more frequent need for noninvasive ventilation, invasive mechanical ventilation; and was associated with higher mortality incidence (hazard ratio [HR] = 7.02; 95% confidence interval [CI], 4.45–11.08; p < .001) than those without myocardial injury. Myocardial injury (HR = 4.55; 95% CI, 2.49–8.31; p < .001), senior age, CRP levels, and novel coronavirus pneumonia types on admission were independent predictors to mortality in COVID‐19 patients. Conclusions COVID‐19 patients with myocardial injury on admission is associated with more severe clinical presentation and biomarkers. Myocardial injury and higher Hs‐TnI are both strongest independent predictors to COVID‐19‐related mortality after adjusting confounding factors.

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Section: Discussionmentioning

confidence: 49%

The prognostic value of myocardial injury in COVID‐19 patients and associated characteristics

Zhang

Zhou

et al. 2021

Immunity Inflam & Disease

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“…These studies examined various aspects of cardiac or myocardial injury among hospitalized patients or patients admitted to the intensive care units. Of all the included studies, 12 (28.5%) were prospective studies [33,35,37,40,42,45,49,55,60,70,72,76]. The 30-day mortality was found to be associated with increased cardiac troponin I (cTnI) (45.1% vs. 23.2%; p=0.005) [33].…”

Section: N Resultsmentioning

confidence: 99%

Myocardial injuries among patients with COVID-19: a systematic review

Alali¹,

Smaisem²,

Alsheikh³

et al. 2021

Infez Med

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This is a systematic review of the literature specifically aimed to explore myocardial injury in coronavirus disease-19 (COVID-19) patients who were hospitalized with severe complicated infections. The medical literature was examined through the large medical databases, including Medline, Ovid, PubMed, and Embase, over the last year between January 2020 and May 2021. The search terms used were a combination of ''myocardial injury'' AND ''COVID-19'' AND "Hospitalization". Then we applied a step to filter the results to select original research articles only evaluating the myocardial injuries in severe COVID-19 hospitalized patients. Selected trials mentioned the type of myocardial injury detected with the infection. A total of 245 articles were extracted. Considering the exclusion of ineligible articles, 42 articles appeared. A total of 42 articles were eligible and were included SUMMARY in the review. These studies included a total of 4326 COVID-19 patients. The 30-day mortality was found to be associated with increased cardiac troponin and myocardial infarction could be a systemic reaction rather than the direct action of COVID-19. Patients with myocardial injury were significantly older and with co-morbid conditions. Studies also found a correlation of higher concentrations of cardiac enzymes with disease severity and increased in-hospital mortality. Myocardial injury was a significant predictor for severe COVID-19 infection and in-hospital mortality. Cardiac enzymes should be monitored in hospitalized patients with severe COVID-19 infections.

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“…A study in the group of 181 COVID-19-positive patients showed 23.2% of them had cardiac injury diagnosed on the basis of elevated biomarkers (high-sensitivity troponin I, myohemoglobin and creatine kinase myocardial (p < 0.001, >99th percentile)). The median age was 55 (IQR, 46-65) years [7]. A study of 2895 COVID-19-positive patients in New York University School of Medicine showed that cardiac injury was present in 16.8% of patients, and troponin levels (>99th percentile, adjusted for sex and age) were considered to be indicative of myocardial necrosis [8].…”

Section: Frequency and Characteristicmentioning

confidence: 99%

“…Cardiac injury was a crucial and independent risk factor for mortality in COVID-19-infected patients [12,[21][22][23] and mortality was usually higher in the cardiac injury group [7,9,[23][24][25]. Patients with cardiac injury were older [7,11,22,26], had more comorbidities [22,25,26], were mostly male [10,22], had more serious disease [7,22,23] or were more likely to require mechanical ventilation [21,22]. Age is an independent predictor of myocardial injury in COVID-19-positive patients [10].…”

Section: Hospitalisation and Outcomementioning

confidence: 99%

Cardiovascular System during SARS-CoV-2 Infection

Koźlik

Błahuszewska

Kaźmierski

2022

IJERPH

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SARS-CoV-2 virus can not only damage the respiratory system but may also pose a threat to other organs, such as the heart or vessels. This review focuses on cardiovascular complications of COVID-19, including acute cardiac injury, arrhythmias, biomarkers, accompanying comorbidities and outcomes in patients diagnosed with SARS-CoV-2 infection. The research was conducted on the databases: PubMed, Springer, ScienceDirect, UpToDate, Oxford Academic, Wiley Online Library, ClinicalKey. Fifty-six publications from 1 November 2020 till 15 August 2021 were included in this study. The results show that cardiac injury is present in about 1 in 4 patients with COVID-19 disease, and it is an independent risk factor, which multiplies the death rate several times in comparison to infected patients without myocardial injury. New-onset cardiac injury occurs in nearly every 10th patient of the COVID-19-suffering population. Comorbidities (such as hypertension, cardiovascular disease and diabetes) severely deteriorate the outcome. Therefore, patients with SARS-CoV-2 infection should be carefully assessed in terms of cardiac medical history and possible cardiological complications.

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Association of coagulation dysfunction with cardiac injury among hospitalized patients with COVID-19

Cited by 10 publications

References 44 publications

The prognostic value of myocardial injury in COVID‐19 patients and associated characteristics

The prognostic value of myocardial injury in COVID‐19 patients and associated characteristics

Myocardial injuries among patients with COVID-19: a systematic review

Cardiovascular System during SARS-CoV-2 Infection

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