Association of Cardiac Injury With Mortality in Hospitalized
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Coronavirus disease 2019 (COVID-19) has resulted in considerable morbidity and mortality worldwide since December 2019. However, information on cardiac injury in patients affected by COVID-19 is limited.

The objective of this study was to explore the association between cardiac injury and mortality in patients with COVID-19.

This cohort study was conducted from January 20, 2020, to February 10, 2020, in a single-center at Renmin Hospital of Wuhan University, Wuhan, China; the final date of follow-up was February 15, 2020. All consecutive inpatients with laboratory-confirmed COVID-19 were included in this study. Clinical laboratory, radiological, and treatment data were collected and analyzed. Outcomes of patients with and without cardiac injury were compared. The association between cardiac injury and mortality was analyzed.

Results: A total of 416 hospitalized patients with COVID-19 were included in the final analysis; the median age was 64 years, and 211 were female. Common symptoms included fever, cough, and shortness of breath. A total of 82 patients had a cardiac injury and compared with patients without cardiac injury, these patients were older; had more comorbidities; had higher leukocyte counts and levels of C-reactive protein, procalcitonin, creatinine kinase–myocardial band, myohemoglobin, high-sensitivity troponin I, N-terminal pro-B-type natriuretic peptide, aspartate aminotransferase, and creatinine; and had a higher proportion of multiple mottling and ground-glass opacity in radiographic findings.

Greater proportions of patients with cardiac injury required noninvasive mechanical ventilation or invasive mechanical ventilation than those without cardiac injury. Complications were more common in patients with cardiac injury than those without cardiac injury and included acute respiratory distress syndrome, acute kidney injury, electrolyte disturbances, hypoproteinemia, and coagulation disorders. Patients with cardiac injury had higher mortality than those without cardiac injury. In a Cox regression model, patients with vs those without cardiac injury were at a higher risk of death, both during the time from symptom onset and from admission to end point.

Conclusively, Cardiac injury is a common condition among hospitalized patients with COVID-19 in Wuhan, China, and it is associated with higher risk of in-hospital mortality.

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