Myocardial Injury Common and Risky in COVID-19

A retrospective cohort study in the US suggested that myocardial injury was prevalent among patients hospitalized with COVID-19, and was associated with higher risk of mortality. The study included 2736 patients (median age 66.4 years, 59.6% men) with COVID-19 admitted between February 27th and April 12th, 2020 with troponin-I (normal value <0.03ng/mL) measured within 24 hours of admission. Cardiovascular disease including coronary artery disease, atrial fibrillation, and heart failure, was more prevalent in patients with higher troponin concentrations, as were hypertension and diabetes. A total of 506 (18.5%) patients died during hospitalization. Even small amounts of myocardial injury (e.g. troponin I 0.03-0.09ng/mL, n=455, 16.6%) were associated with death (adjusted HR: 1.77) while greater amounts (e.g. troponin I>0.09 ng/mL, n=530, 19.4%) were associated with more pronounced risk (adjusted HR 3.23). Two smaller reports from China had some similar findings and supported a theory of non-ischemic myocardial injury in COVID-19. Source: https://www.medrxiv.org/