Myocardial Injury on Admission as a Risk in Critically Ill COVID-19 Patients: A Retrospective in-ICU Study.
OBJECTIVE
The aim of this study was to investigate the incidence, clinical presentation, cardiovascular (CV) complications, and mortality risk of myocardial injury on admission in critically ill intensive care unit (ICU) inpatients with COVID-19.


DESIGN
A single-center, retrospective, observational study.


SETTING
A newly built ICU in Tongji hospital (Sino-French new city campus), Huazhong University of Science and Technology, Wuhan, China.


PARTICIPANTS
Seventy-seven critical COVID-19 patients.


INTERVENTIONS
Patients were divided into a myocardial injury group and nonmyocardial injury group according to the on-admission levels of high-sensitivity cardiac troponin I.


MEASUREMENTS AND MAIN RESULTS
Demographic data, clinical characteristics, laboratory tests, treatment, and clinical outcome were evaluated, stratified by the presence of myocardial injury on admission. Compared with nonmyocardial injury patients, patients with myocardial injury were older (68.4 ± 10.1 v 62.1 ± 13.5 years; p = 0.02), had higher prevalence of underlying CV disease (34.1% v 11.1%; p = 0.02), and in-ICU CV complications (41.5% v 13.9%; p = 0.008), higher Acute Physiology and Chronic Health Evaluation II scores (20.3 ± 7.3 v 14.4 ± 7.4; p = 0.001), and Sequential Organ Failure Assessment scores (7, interquartile range (IQR) 5-10 v 5, IQR 3-6; p < 0.001). Myocardial injury on admission increased the risk of 28-day mortality (hazard ratio [HR], 2.200; 95% confidence interval [CI] 1.29 to 3.74; p = 0.004). Age ≥75 years was another risk factor for mortality (HR, 2.882; 95% CI 1.51-5.50; p = 0.002).


CONCLUSION
Critically ill patients with COVID-19 had a high risk of CV complications. Myocardial injury on admission may be a common comorbidity and is associated with severity and a high risk of mortality in this population.
['Qian|Hao|H|', 'Gao|Peng|P|', 'Tian|Ran|R|', 'Yang|Xufei|X|', 'Guo|Fan|F|', 'Li|Taisheng|T|', 'Liu|Zhengyin|Z|', 'Wang|Jinglan|J|', 'Zhou|Xiang|X|', 'Qin|Yan|Y|', 'Chang|Long|L|', 'Song|Yanjun|Y|', 'Yan|Xiaowei|X|', 'Wu|Wei|W|', 'Zhang|Shuyang|S|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D000086382:COVID-19 D002318:Cardiovascular Diseases D016638:Critical Illness D005260:Female D006801:Humans D007362:Intensive Care Units D008297:Male D008875:Middle Aged D010343:Patient Admission D012189:Retrospective Studies D012307:Risk Factors
myocardial injury critically ill cardiovascular complication novel coronavirus disease