Death, discharge and arrhythmias among patients with COVID-19 and cardiac injury.
Anti-Arrhythmia Agents
/ therapeutic use
Arrhythmias, Cardiac
/ blood
Betacoronavirus
/ pathogenicity
Biomarkers
/ blood
COVID-19
China
/ epidemiology
Coronavirus Infections
/ blood
Critical Illness
Heart Injuries
/ blood
Hospital Mortality
Humans
Intensive Care Units
Logistic Models
Pandemics
Patient Discharge
/ statistics & numerical data
Pneumonia, Viral
/ blood
Prognosis
Respiration, Artificial
/ statistics & numerical data
Retrospective Studies
SARS-CoV-2
Troponin I
/ blood
Journal
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
ISSN: 1488-2329
Titre abrégé: CMAJ
Pays: Canada
ID NLM: 9711805
Informations de publication
Date de publication:
13 07 2020
13 07 2020
Historique:
accepted:
09
06
2020
pubmed:
27
6
2020
medline:
25
7
2020
entrez:
27
6
2020
Statut:
ppublish
Résumé
Cardiac injury is common in severe coronavirus disease 2019 (COVID-19) and is associated with poor outcomes. We aimed to study predictors of in-hospital death, characteristics of arrhythmias and the effects of QT-prolonging therapy in patients with cardiac injury. We conducted a retrospective cohort study involving patients with severe COVID-19 who were admitted to Tongji Hospital in Wuhan, China, between Jan. 29 and Mar. 8, 2020. Among patients who had cardiac injury, which we defined as an elevated level of cardiac troponin I (cTnI), we identified demographic and clinical characteristics associated with mortality and need for invasive ventilation. Among 1284 patients with severe COVID-19, 1159 had a cTnI level measured on admission to hospital, of whom 170 (14.7%) had results that showed cardiac injury. We found that mortality was markedly higher in patients with cardiac injury (71.2% v. 6.6%, We found that in patients with COVID-19 and cardiac injury, initial and peak cTnI levels were associated with poor survival, and peak cTnI was a predictor of need for invasive ventilation. Patients with COVID-19 warrant assessment for cardiac injury and monitoring, especially if therapy that can prolong repolarization is started. Chinese Clinical Trial Registry, No. ChiCTR2000031301.
Sections du résumé
BACKGROUND
Cardiac injury is common in severe coronavirus disease 2019 (COVID-19) and is associated with poor outcomes. We aimed to study predictors of in-hospital death, characteristics of arrhythmias and the effects of QT-prolonging therapy in patients with cardiac injury.
METHODS
We conducted a retrospective cohort study involving patients with severe COVID-19 who were admitted to Tongji Hospital in Wuhan, China, between Jan. 29 and Mar. 8, 2020. Among patients who had cardiac injury, which we defined as an elevated level of cardiac troponin I (cTnI), we identified demographic and clinical characteristics associated with mortality and need for invasive ventilation.
RESULTS
Among 1284 patients with severe COVID-19, 1159 had a cTnI level measured on admission to hospital, of whom 170 (14.7%) had results that showed cardiac injury. We found that mortality was markedly higher in patients with cardiac injury (71.2% v. 6.6%,
INTERPRETATION
We found that in patients with COVID-19 and cardiac injury, initial and peak cTnI levels were associated with poor survival, and peak cTnI was a predictor of need for invasive ventilation. Patients with COVID-19 warrant assessment for cardiac injury and monitoring, especially if therapy that can prolong repolarization is started.
TRIAL REGISTRATION
Chinese Clinical Trial Registry, No. ChiCTR2000031301.
Identifiants
pubmed: 32586839
pii: cmaj.200879
doi: 10.1503/cmaj.200879
pmc: PMC7828865
doi:
Substances chimiques
Anti-Arrhythmia Agents
0
Biomarkers
0
Troponin I
0
Banques de données
ChiCTR
['ChiCTR2000031301']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
E791-E798Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 Joule Inc. or its licensors.
Déclaration de conflit d'intérêts
Competing interests: Kumaraswamy Nanthakumar is supported by grants from the Canadian Institutes of Health Research, is an Investigator with the Heart and Stroke Foundation and is a consultant for Servier, Biosense Webster, Abbott Laboratories and BlueRock Therapeutics. Stéphane Massé is a consultant for Abbott Laboratories. No other competing interests were declared.
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