International Journal of Cardiovascular Sciences. 20/Aug/2021;35(1):58-64.

Predictive Value of Myocardial injury in Patients with COVID-19 Admitted to a Quaternary Hospital in the City of Rio de Janeiro

Antônio Sérgio Cordeiro da Rocha , Andre Volschan , Luiz Antonio Almeida Campos, Roberta Pereira dos Santos Coelho, Dominique Cardoso de Almeida Thielmann, Carlos Augusto Lobbe Cotta Ferreira, Alexandre Siciliano Colafranceschi

DOI: 10.36660/ijcs.20200352

Abstract

Background

In Brazil the factors involved in the risk of death in patients with COVID-19 have not been well established.

Objective

To analyze whether elevations of high-sensitivity troponin I (hTnI) levels influence the mortality of patients with COVID-19.

Methods

Clinical and laboratory characteristics of hospitalized patients with COVID-19 were collected upon hospital admission. Univariate and binary logistic regression analyzes were performed to assess the factors that influence mortality. P-value<0.05 was considered significant.

Results

This study analyzed192 patients who received hospital admission between March 16 and June 2, 2020 and who were discharged or died by July 2, 2020. The mean age was 70±15 years, 80 (41.7%) of whom were women. In comparison to those who were discharged, the 54 (28.1%) who died were older (79±12 vs 66±15years; P=0.004), and with a higher Charlson´s index (5±2 vs 3±2; P=0.027). More patients, aged≥60years (P <0.0001), Charlson´s index>1 (P=0.004), lung injury>50% in chest computed tomography (P=0.011), with previous coronary artery disease (P=0.037), hypertension (P=0.033), stroke (P=0.008), heart failure (P=0.002), lymphocytopenia (P=0.024), high D-dimer (P=0.024), high INR (P=0.003), hTnI (P<0.0001), high creatinine (P<0.0001), invasive mechanical ventilation (P<0.0001), renal replacement therapy (P<0.0001), vasoactive amine (P<0.0001), and transfer to the ICU (P=0.001), died when compared to those who were discharged. In logistic regression analysis, elevated hTnI levels (OR=9.504; 95% CI=1.281–70.528; P=0.028) upon admission, and the need for mechanical ventilation during hospitalization (OR=46.691; 95% CI=2.360–923.706; P=0.012) increased the chance of in-hospital mortality.

Conclusion

This study suggests that in COVID-19 disease, myocardial injury upon hospital admission is a harbinger of poor prognosis.