Subclinical Myocardial Injury, Coagulopathy, and Inflammation in COVID-19: A Meta-Analysis of 41,013 Hospitalized Patients

Ogungbe, Oluwabunmi; Kumbe, Baridosia; Fadodun, Oluwadamilola; Latha, T; Meyer, Diane; Asala, Adetoun; Davidson, Patricia M.; Himmelfarb, Cheryl Dennison; Post, Wendy S.; Commodore-Mensah, Yvonne

doi:10.2139/ssrn.3950210

Cited by 4 publications

(6 citation statements)

References 50 publications

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“…Under these conditions of equality, the development of STEMI in patients with recent SARS-CoV-2 infection occurred in a context of lower baseline cardiovascular risk, as evidenced by the lower frequency of systemic hypertension and the trend towards a lower Charlson comorbidity index and Q-RISK3 score. This parallels the recent demonstration of myocardial injury and coagulopathy as a complication of COVID-19 10 . Although the durability of these complications and their real contribution to the development of ACS are still being investigated, the evidence suggests that recent SARS-CoV-2 infection could already be considered an independent cardiovascular risk factor, albeit parallel to those considered traditional.…”

Section: Discussionsupporting

confidence: 73%

¿Debe considerarse una infección reciente por SARS-CoV-2 como un factor de riesgo o pronóstico de infarto de miocardio con elevación del segmento ST?

Díaz-Domínguez¹,

Amezcua-Castillo²,

Guerra-López³

et al. 2024

ACM

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Objective:The aim of the study was to assess whether a recent SARS-CoV-2 infection could by itself be a risk or prognostic factor for ST-segment elevation myocardial infarction (STEMI). Method: An observational study in unvaccinated patients with STEMI confirmed by cardiac catheterization was conducted. A recent or concurrent SARS-CoV-2 infection was identified by the presence of serum IgG against the nucleocapsid protein, or a positive polymerase chain reaction test on nasopharyngeal swabs. Baseline cardiovascular risk factors, clinical STEMI severity, main catheterization findings, and occurrence of major adverse cardiovascular events (MACE) during hospitalization were compared between study subgroups. Results: Of a total of 89 patients recruited, 14 (16%) had a recent SARS-CoV-2 infection. Patients with STEMI and recent SARS-CoV-2 infection had a markedly lower frequency of high blood pressure (20% versus 55%; P = 0.03) as well as a tendency to have fewer comorbidities. Regarding the clinical presentation, there were no differences in the severity of the STEMI. Furthermore, the main findings during cardiac catheterization including the atherosclerotic burden and the number of vessels affected, as well as the occurrence of MACE during follow-up, were not significantly different between the groups. Conclusions: A recent SARS-CoV-2 infection appears to facilitate the triggering of STEMI, as these patients have fewer traditional cardiovascular risk factors than their uninfected counterparts. However, this does not seem to affect the clinical presentation or the in-hospital course of STEMI patients.

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Section: Discussionsupporting

confidence: 73%

¿Debe considerarse una infección reciente por SARS-CoV-2 como un factor de riesgo o pronóstico de infarto de miocardio con elevación del segmento ST?

Díaz-Domínguez¹,

Amezcua-Castillo²,

Guerra-López³

et al. 2024

ACM

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“…The majority of studies (46 studies) reported the impact of CI on mortality (Table 1) [5,12,15,17,18,20,[22][23][24]29,[31][32][33]35,39,40,[42][43][44][45][46][47][48][49][50][51][52][53][56][57][58][59][60][61][62][63][64][65][66][67]70,73,74,[76][77][78].…”

Section: Resultsmentioning

confidence: 99%

“…Among the different statistical indices, OR was the most frequently used (29 studies) [4,5,12,21,22,[24][25][26][27][32][33][34]40,[42][43][44]47,48,50,52,58,59,[62][63][64]70,74,77,78], while RR and HR were used in 10 [15,18,23,39,45,48,56,57,72,73] and 6 studies [51,52,60,65,66,77], respectively. A minority of meta-analyses investigated pooled differences of cardiac biomarkers between severe vs non-severe disease or survivors vs non survivors (Table 1).…”

Section: Resultsmentioning

confidence: 99%

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Cardiac Injury in COVID-19: A Systematic Review of Relevant Meta-Analyses

Kyriakoulis¹,

Kyriakoulis²,

Trontzas³

et al. 2022

Rev. Cardiovasc. Med.

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Background: Cardiac injury (CI) is not a rare condition among hospitalized patients with coronavirus disease 2019 . Its prognostic value has been extensively reported through the literature, mainly in the context of observational studies. An impressive number of relevant meta-analyses has been conducted. These meta-analyses present similar and consistent results; yet interesting methodological issues emerge. Methods: A systematic literature search was conducted aiming to identify all relevant meta-analyses on (i) the incidence, and (ii) the prognostic value of CI among hospitalized patients with COVID-19. Results: Among 118 articles initially retrieved, 73 fulfilled the inclusion criteria and were included in the systematic review. Various criteria were used for CI definition mainly based on elevated cardiac biomarkers levels. The most frequently used biomarker was troponin. 30 meta-analyses reported the pooled incidence of CI in hospitalized patients with COVID-19 that varies from 5% to 37%. 32 meta-analyses reported on the association of CI with COVID-19 infection severity, with only 6 of them failing to show a statistically significant association. Finally, 46 meta-analyses investigated the association of CI with mortality and showed that patients with COVID-19 with CI had increased risk for worse prognosis. Four meta-analyses reported pooled adjusted hazard ratios for death in patients with COVID-19 and CI vs those without CI ranging from 1.5 to 3. Conclusions: The impact of CI on the prognosis of hospitalized patients with COVID-19 has gained great interest during the pandemic. Methodological issues such as the inclusion of not peer-reviewed studies, the inclusion of potentially overlapping populations or the inclusion of studies with unadjusted analyses for confounders should be taken into consideration. Despite these limitations, the adverse prognosis of patients with COVID-19 and CI has been consistently demonstrated.

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“…The hemostatic derailment precipitated by COVID-19 proved a major challenge also for the management of the approximately 20 % of patients who developed in-hospital atrial fibrillation (AF). Gawalko et al [3] provided a comprehensive overview of the available data on the prevalence and molecular mechanisms of AF in the context of COVID-19, and outlined potential options for acute and long-term treatment Two years on, the long-term impact of COVID-19 after recovery from the acute infection was neatly assessed by a comprehensive meta -analysis performed by Ogungbe et al [4] encompassing 62 articles published during December 2019-August 2021 and including over 41,000 patients. Infection with COVID-19 was associated with severely increased rate of myocardial damage and coagulopathy, raising clear implications for long-term cardiovascular health.…”

Section: Covid-19 – Tiny Entity Enormous Challengementioning

confidence: 99%

Recent highlights on thrombosis and hemostasis from the International Journal of Cardiology: Heart & Vasculature

Fender¹,

Dobrev²

2022

IJC Heart & Vasculature

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Subclinical Myocardial Injury, Coagulopathy, and Inflammation in COVID-19: A Meta-Analysis of 41,013 Hospitalized Patients

Cited by 4 publications

References 50 publications

¿Debe considerarse una infección reciente por SARS-CoV-2 como un factor de riesgo o pronóstico de infarto de miocardio con elevación del segmento ST?

¿Debe considerarse una infección reciente por SARS-CoV-2 como un factor de riesgo o pronóstico de infarto de miocardio con elevación del segmento ST?

Cardiac Injury in COVID-19: A Systematic Review of Relevant Meta-Analyses

Recent highlights on thrombosis and hemostasis from the International Journal of Cardiology: Heart & Vasculature

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