Prognostic significance of cardiac injury in COVID-19 patients with and without coronary artery disease

Barman, Hasan Ali; Atıcı, Adem; Şahin, İrfan; Alıcı, Gökhan; Tekin, Esra Aktaş; Baycan, Ömer Faruk; Öztürk, Fatih; Oflar, Ersan; Tuğrul, Sevil; Yavuz, Mustafa; Çelik, Fatma; Oktay, Aysu; Vahaboğlu, Haluk; Adaş, Mine; Turgut, Namigar; Okuyan, Ertuğrul; Yildirmak, Mustafa Taner; Güngör, Barış

doi:10.1097/mca.0000000000000914

Cited by 72 publications

(76 citation statements)

References 21 publications

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“…The sMVAP index proves to be a practical OSAHS screening tool [ 3 ], including parameters such as age, gender, and BMI that only need to be extracted from the patient's electronic medical record. In this current study, the increased D-dimer and history of coronary heart disease were associated with poor prognosis, reflecting the direct effect of patients' coagulation function and cardiac dysfunction on mortality, consistent with previous reports [ 19 , 20 ].…”

Section: Discussionsupporting

confidence: 92%

Symptomless multi-variable apnea prediction index assesses adverse outcomes in patients with Corona Virus Disease 2019

Zhang

et al. 2020

Sleep Medicine

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Purpose To explore the relationship between symptomless multi-Variable apnea prediction (sMVAP) index and adverse outcomes of patients with Corona Virus Disease 2019 (COVID-19). Methods According to the sMVAP quartiles, we divided all patients into four groups. The clinical electronic medical records, nursing records, laboratory findings, and radiological examinations for all patients with laboratory confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection were reviewed. Cox proportional hazard ratio (HR) models were used to determine the risk factors associated with in hospital death. Results A total of 97 patients were included in this study. The “Quartile 4” group 's ICU transfer rate was significantly higher than the “Quartile 1” group. Coronary heart disease, high d-dimer and sMVAP at admission were associated with increased odds of death. Conclusions Using the sMVAP index for obstructive sleep apnea hypopnea syndrome (OSAHS) risk assessment, and then predicting the adverse outcomes of COVID-19 patients, is an effective method. Therefore, the use of sMVAP index for OSAHS screening for inpatients with COVID-19 should be vigorously promoted, and high-risk patients should be effectively managed.

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Section: Discussionsupporting

confidence: 92%

Symptomless multi-variable apnea prediction index assesses adverse outcomes in patients with Corona Virus Disease 2019

Zhang

et al. 2020

Sleep Medicine

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“…It has been previously reported that troponin levels are higher and troponin elevations more common among non‐survivors with COVID‐19 2,8‐11 . A recent multi‐center retrospective study including 607 hospitalized patients with COVID‐19, found elevated troponin independently predicting mortality in patients with or without coronary artery disease, similar to our report 11 . These reports, along with our cohort, reveal a strikingly consistent rate of myocardial injury on admission among these patients‐about 20% to 25% despite a variable incidence of confounding factors like pre‐existing cardiac disease or renal disease.…”

Section: Discussionsupporting

confidence: 90%

Is it all in the heart? Myocardial injury as major predictor of mortality among hospitalized COVID‐19 patients

Harmouch

Shah

Hippen

et al. 2020

Journal of Medical Virology

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Coronavirus disease 2019 (COVID-19) is an infection caused by the virus SARS-CoV-2, and has caused the most widespread global pandemic in over 100 years. Given the novelty of the disease, risk factors of mortality and adverse outcomes in hospitalized patients remain to be elucidated. We present the results of a retrospective cohort study including patients admitted to a large tertiary-care, academic university hospital with COVID-19. Patients were admitted with confirmed diagnosis of COVID-19 between 1 March and 15 April 2020. Baseline clinical characteristics and admission laboratory variables were retrospectively collected. Patients were grouped based on mortality, need for ICU care, and mechanical ventilation. Prevalence of clinical co-morbidities and laboratory abnormalities were compared between groups using descriptive statistics. Univariate analysis was performed to identify predictors of mortality, ICU care and mechanical ventilation. Predictors significant at P ≤ .10 were included in multivariate analysis. Five hundred and sixty patients were included in the analysis. Age and myocardial injury were only independent predictors of mortality, in patients with/without baseline co-morbidities. Body mass index, elevated ferritin, elevated d-dimer, and elevated procalcitonin predicted need for ICU care, and these along with vascular disease at baseline predicted need for mechanical ventilation. Hence, inflammatory markers (ferritin and d-dimer) predicted severe disease, but not death.

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“…Evaluation of increased CRP showed that baseline level over 10 , p = 0.001, I 2 = 14.7%, respectively), however, the analysis regarding the threshold of 50 mg/L was not significant, which makes these results inconsistent. In case of intensive care Fig.…”

Section: Odds Ratiosmentioning

confidence: 90%

Early changes in laboratory parameters are predictors of mortality and ICU admission in patients with COVID-19: a systematic review and meta-analysis

Kiss

Gede

Németh

et al. 2020

Med Microbiol Immunol

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Despite the growing knowledge of the clinicopathological features of COVID-19, the correlation between early changes in the laboratory parameters and the clinical outcomes of patients is not entirely understood. In this study, we aimed to assess the prognostic value of early laboratory parameters in COVID-19. We conducted a systematic review and meta-analysis based on the available literature in five databases. The last search was on July 26, 2020, with key terms related to COVID-19. Eligible studies contained original data of at least ten infected patients and reported on baseline laboratory parameters of patients. We calculated weighted mean differences (WMDs) for continuous outcomes and odds ratios (ORs) with 95% confidence intervals. 93 and 78 studies were included in quantitative and qualitative syntheses, respectively. Higher baseline total white blood cell count (WBC), C-reactive protein (CRP), lactate-dehydrogenase (LDH), creatine kinase (CK), D-dimer and lower absolute lymphocyte count (ALC) (WMDALC = − 0.35 × 109/L [CI − 0.43, − 0.27], p < 0.001, I2 = 94.2%; < 0.8 × 109/L, ORALC = 3.74 [CI 1.77, 7.92], p = 0.001, I2 = 65.5%) were all associated with higher mortality rate. On admission WBC, ALC, D-dimer, CRP, LDH, and CK changes could serve as alarming prognostic factors. The correct interpretation of laboratory abnormalities can guide therapeutic decisions, especially in early identification of potentially critical cases. This meta-analysis should help to allocate resources and save lives by enabling timely intervention.

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Prognostic significance of cardiac injury in COVID-19 patients with and without coronary artery disease

Cited by 72 publications

References 21 publications

Symptomless multi-variable apnea prediction index assesses adverse outcomes in patients with Corona Virus Disease 2019

Symptomless multi-variable apnea prediction index assesses adverse outcomes in patients with Corona Virus Disease 2019

Is it all in the heart? Myocardial injury as major predictor of mortality among hospitalized COVID‐19 patients

Early changes in laboratory parameters are predictors of mortality and ICU admission in patients with COVID-19: a systematic review and meta-analysis

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