Myocardial Injury on Admission as a Risk in Critically Ill COVID-19 Patients: A Retrospective in-ICU Study
•Myocardial injury is common in critically ill COVID-19 patients.•COVID-19 patients with myocardial injury are more likely to develop adverse events and fatal outcomes during the hospitalization.•Myocardial injury and advanced age (≥75 yrs old) are independent risk factors for 28-day in-ICU mortalit...
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| Veröffentlicht in: | Journal of cardiothoracic and vascular anesthesia 2021-03, Vol.35 (3), p.846-853 |
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| creator | Qian, Hao Gao, Peng Tian, Ran Yang, Xufei Guo, Fan Li, Taisheng Liu, Zhengyin Wang, Jinglan Zhou, Xiang Qin, Yan Chang, Long Song, Yanjun Yan, Xiaowei Wu, Wei Zhang, Shuyang |
| description | •Myocardial injury is common in critically ill COVID-19 patients.•COVID-19 patients with myocardial injury are more likely to develop adverse events and fatal outcomes during the hospitalization.•Myocardial injury and advanced age (≥75 yrs old) are independent risk factors for 28-day in-ICU mortality.
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.
A single-center, retrospective, observational study.
A newly built ICU in Tongji hospital (Sino-French new city campus), Huazhong University of Science and Technology, Wuhan, China.
Seventy-seven critical COVID-19 patients.
Patients were divided into a myocardial injury group and nonmyocardial injury group according to the on-admission levels of high-sensitivity cardiac troponin I.
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).
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. |
| doi_str_mv | 10.1053/j.jvca.2020.10.019 |
| format | Article |
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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.
A single-center, retrospective, observational study.
A newly built ICU in Tongji hospital (Sino-French new city campus), Huazhong University of Science and Technology, Wuhan, China.
Seventy-seven critical COVID-19 patients.
Patients were divided into a myocardial injury group and nonmyocardial injury group according to the on-admission levels of high-sensitivity cardiac troponin I.
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).
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.</description><identifier>ISSN: 1053-0770</identifier><identifier>EISSN: 1532-8422</identifier><identifier>DOI: 10.1053/j.jvca.2020.10.019</identifier><identifier>PMID: 33162306</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; cardiovascular complication ; Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - mortality ; Cardiovascular Diseases - therapy ; COVID-19 - diagnosis ; COVID-19 - mortality ; COVID-19 - therapy ; Critical Illness - mortality ; Critical Illness - therapy ; critically ill ; Female ; Humans ; Intensive Care Units - trends ; Male ; Middle Aged ; myocardial injury ; novel coronavirus disease ; Original ; Patient Admission - trends ; Retrospective Studies ; Risk Factors</subject><ispartof>Journal of cardiothoracic and vascular anesthesia, 2021-03, Vol.35 (3), p.846-853</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><rights>2020 Elsevier Inc. All rights reserved. 2020 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-39b24b59d4e2afc81d5e328e1a68bce728d2e8307f93a5a423c8ad9aeddd79463</citedby><cites>FETCH-LOGICAL-c455t-39b24b59d4e2afc81d5e328e1a68bce728d2e8307f93a5a423c8ad9aeddd79463</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1053077020311332$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33162306$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Qian, Hao</creatorcontrib><creatorcontrib>Gao, Peng</creatorcontrib><creatorcontrib>Tian, Ran</creatorcontrib><creatorcontrib>Yang, Xufei</creatorcontrib><creatorcontrib>Guo, Fan</creatorcontrib><creatorcontrib>Li, Taisheng</creatorcontrib><creatorcontrib>Liu, Zhengyin</creatorcontrib><creatorcontrib>Wang, Jinglan</creatorcontrib><creatorcontrib>Zhou, Xiang</creatorcontrib><creatorcontrib>Qin, Yan</creatorcontrib><creatorcontrib>Chang, Long</creatorcontrib><creatorcontrib>Song, Yanjun</creatorcontrib><creatorcontrib>Yan, Xiaowei</creatorcontrib><creatorcontrib>Wu, Wei</creatorcontrib><creatorcontrib>Zhang, Shuyang</creatorcontrib><title>Myocardial Injury on Admission as a Risk in Critically Ill COVID-19 Patients: A Retrospective in-ICU Study</title><title>Journal of cardiothoracic and vascular anesthesia</title><addtitle>J Cardiothorac Vasc Anesth</addtitle><description>•Myocardial injury is common in critically ill COVID-19 patients.•COVID-19 patients with myocardial injury are more likely to develop adverse events and fatal outcomes during the hospitalization.•Myocardial injury and advanced age (≥75 yrs old) are independent risk factors for 28-day in-ICU mortality.
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.
A single-center, retrospective, observational study.
A newly built ICU in Tongji hospital (Sino-French new city campus), Huazhong University of Science and Technology, Wuhan, China.
Seventy-seven critical COVID-19 patients.
Patients were divided into a myocardial injury group and nonmyocardial injury group according to the on-admission levels of high-sensitivity cardiac troponin I.
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).
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.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>cardiovascular complication</subject><subject>Cardiovascular Diseases - diagnosis</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Cardiovascular Diseases - therapy</subject><subject>COVID-19 - diagnosis</subject><subject>COVID-19 - mortality</subject><subject>COVID-19 - therapy</subject><subject>Critical Illness - mortality</subject><subject>Critical Illness - therapy</subject><subject>critically ill</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive Care Units - trends</subject><subject>Male</subject><subject>Middle Aged</subject><subject>myocardial injury</subject><subject>novel coronavirus disease</subject><subject>Original</subject><subject>Patient Admission - trends</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><issn>1053-0770</issn><issn>1532-8422</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU1v1DAQtRAVLYU_wAH5yCWLP-J8IIS0Ch-NVFRUKFdr1p4FB2-ytZOV8u9xtG1FL5xmNH7veeY9Ql5xtuJMybfdqjsYWAkmlsGK8foJOeNKiqzKhXia-oTKWFmyU_I8xo4xzpUqn5FTKXkhJCvOSPd1HgwE68DTtu-mMNOhp2u7czG61EGkQK9d_ENdT5vgRmfA-5m23tPm6mf7MeM1_Qajw36M7-iaXuMYhrhHM7oDJlLWNjf0-zjZ-QU52YKP-PKunpObz59-NBfZ5dWXtllfZiZXasxkvRH5RtU2RwFbU3GrUIoKORTVxmApKiuwkqzc1hIU5EKaCmwNaK0t67yQ5-TDUXc_bXZoTdosgNf74HYQZj2A049fevdb_xoOulRFUZQyCby5EwjD7YRx1MkNg95Dj8MUtchVVSvFizxBxRFq0tEx4PbhG870Yr_u9BKSXkJaZimkRHr974IPlPtUEuD9EYDJpoPDoKNJBhu0LiRjtR3c__T_AoBco44</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Qian, Hao</creator><creator>Gao, Peng</creator><creator>Tian, Ran</creator><creator>Yang, Xufei</creator><creator>Guo, Fan</creator><creator>Li, Taisheng</creator><creator>Liu, Zhengyin</creator><creator>Wang, Jinglan</creator><creator>Zhou, Xiang</creator><creator>Qin, Yan</creator><creator>Chang, Long</creator><creator>Song, Yanjun</creator><creator>Yan, Xiaowei</creator><creator>Wu, Wei</creator><creator>Zhang, Shuyang</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210301</creationdate><title>Myocardial Injury on Admission as a Risk in Critically Ill COVID-19 Patients: A Retrospective in-ICU Study</title><author>Qian, Hao ; Gao, Peng ; Tian, Ran ; Yang, Xufei ; Guo, Fan ; Li, Taisheng ; Liu, Zhengyin ; Wang, Jinglan ; Zhou, Xiang ; Qin, Yan ; Chang, Long ; Song, Yanjun ; Yan, Xiaowei ; Wu, Wei ; Zhang, Shuyang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-39b24b59d4e2afc81d5e328e1a68bce728d2e8307f93a5a423c8ad9aeddd79463</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>cardiovascular complication</topic><topic>Cardiovascular Diseases - diagnosis</topic><topic>Cardiovascular Diseases - mortality</topic><topic>Cardiovascular Diseases - therapy</topic><topic>COVID-19 - diagnosis</topic><topic>COVID-19 - mortality</topic><topic>COVID-19 - therapy</topic><topic>Critical Illness - mortality</topic><topic>Critical Illness - therapy</topic><topic>critically ill</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive Care Units - trends</topic><topic>Male</topic><topic>Middle Aged</topic><topic>myocardial injury</topic><topic>novel coronavirus disease</topic><topic>Original</topic><topic>Patient Admission - trends</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Qian, Hao</creatorcontrib><creatorcontrib>Gao, Peng</creatorcontrib><creatorcontrib>Tian, Ran</creatorcontrib><creatorcontrib>Yang, Xufei</creatorcontrib><creatorcontrib>Guo, Fan</creatorcontrib><creatorcontrib>Li, Taisheng</creatorcontrib><creatorcontrib>Liu, Zhengyin</creatorcontrib><creatorcontrib>Wang, Jinglan</creatorcontrib><creatorcontrib>Zhou, Xiang</creatorcontrib><creatorcontrib>Qin, Yan</creatorcontrib><creatorcontrib>Chang, Long</creatorcontrib><creatorcontrib>Song, Yanjun</creatorcontrib><creatorcontrib>Yan, Xiaowei</creatorcontrib><creatorcontrib>Wu, Wei</creatorcontrib><creatorcontrib>Zhang, Shuyang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Qian, Hao</au><au>Gao, Peng</au><au>Tian, Ran</au><au>Yang, Xufei</au><au>Guo, Fan</au><au>Li, Taisheng</au><au>Liu, Zhengyin</au><au>Wang, Jinglan</au><au>Zhou, Xiang</au><au>Qin, Yan</au><au>Chang, Long</au><au>Song, Yanjun</au><au>Yan, Xiaowei</au><au>Wu, Wei</au><au>Zhang, Shuyang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Myocardial Injury on Admission as a Risk in Critically Ill COVID-19 Patients: A Retrospective in-ICU Study</atitle><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle><addtitle>J Cardiothorac Vasc Anesth</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>35</volume><issue>3</issue><spage>846</spage><epage>853</epage><pages>846-853</pages><issn>1053-0770</issn><eissn>1532-8422</eissn><abstract>•Myocardial injury is common in critically ill COVID-19 patients.•COVID-19 patients with myocardial injury are more likely to develop adverse events and fatal outcomes during the hospitalization.•Myocardial injury and advanced age (≥75 yrs old) are independent risk factors for 28-day in-ICU mortality.
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.
A single-center, retrospective, observational study.
A newly built ICU in Tongji hospital (Sino-French new city campus), Huazhong University of Science and Technology, Wuhan, China.
Seventy-seven critical COVID-19 patients.
Patients were divided into a myocardial injury group and nonmyocardial injury group according to the on-admission levels of high-sensitivity cardiac troponin I.
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).
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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33162306</pmid><doi>10.1053/j.jvca.2020.10.019</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of cardiothoracic and vascular anesthesia, 2021-03, Vol.35 (3), p.846-853 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Aged Aged, 80 and over cardiovascular complication Cardiovascular Diseases - diagnosis Cardiovascular Diseases - mortality Cardiovascular Diseases - therapy COVID-19 - diagnosis COVID-19 - mortality COVID-19 - therapy Critical Illness - mortality Critical Illness - therapy critically ill Female Humans Intensive Care Units - trends Male Middle Aged myocardial injury novel coronavirus disease Original Patient Admission - trends Retrospective Studies Risk Factors |
| title | Myocardial Injury on Admission as a Risk in Critically Ill COVID-19 Patients: A Retrospective in-ICU Study |
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