■由肌钙蛋白I水平升高定义的急性心肌损伤与COVID-19患者的不良住院结局和心血管并发症相关。本研究旨在确定COVID-19心肌损伤的影响和临床结果。
■这项回顾性研究包括住院的COVID-19患者。心肌损伤定义为高敏肌钙蛋白I(hs-TNI)≥26ng/l。心脏生物标志物,系统收集和分析炎症标志物和临床数据.分析了院内死亡率的危险比和急性心肌损伤预测因子的逻辑回归。
■在1821例COVID-19患者中,有293例(16.09%)患者死亡,1528例(83.91%)患者存活。死亡患者与心血管危险因素的相关性明显更高,与存活组相比,严重CTSS(CT严重程度评分)和心肌损伤。628例(34.5%)患者有心肌损伤的证据,他们与心血管危险因素有统计学意义的关联,住院死亡率,降钙素原;高等医院,ICCU留下。我们发现糖尿病的危险比显著(HR=2.66,(CI:1.65-4.29)),严重CT评分(HR=2.81,(CI:1.74-4.52)),hs-TNI≥26ng/l(HR=4.68,(CI:3.81-5.76))的死亡率。在回归分析中,严重CTSS评分(OR=1.95,CI:1.18-3.23,P=0.01)和既往CVD病史(OR=1.65,CI:1.00-2.73,P=0.05)是心肌损伤的重要预测因素。
■近三分之一的住院患者在住院期间有急性心肌损伤的证据。急性心肌损伤与住院和ICCU住院时间有关,死亡率,较高的院内感染表明疾病更严重和不良的院内结局。
UNASSIGNED: Acute Myocardial injury defined by increased troponin I level is associated with poor in-hospital outcomes and cardiovascular complications in patients with COVID-19. The current study was designed to determine the implications and clinical outcome of myocardial injury in COVID-19.
UNASSIGNED: This retrospective study included hospitalized COVID-19 patients. Myocardial injury was defined by high sensitivity Troponin I (hs-TNI)≥26ng/l. Cardiac biomarkers, inflammatory markers and clinical data were systemically collected and analyzed. Hazard ratio for in-hospital mortality and logistic regression for predictors of acute myocardial injury were analyzed.
UNASSIGNED: Of the 1821 total patients with COVID-19, 293(16.09%) patients died and 1528 (83.91%) patients survived. Patients who died had significantly higher association with presence of cardiovascular risk factors, severe CTSS ( CT severity score ) and myocardial injury as compared to survived group. 628 (34.5%) patients had evidence of myocardial injury and they had statistically significant association with cardiovascular risk factors, in-hospital mortality, procalcitonin; higher hospital, and ICCU stay. We found significant hazard ratio of diabetes (HR=2.66, (CI:1.65-4.29)), Severe CT score (HR=2.81, (CI:1.74-4.52)), hs-TNI≥26 ng/l (HR=4.68, (CI:3.81-5.76)) for mortality. Severe CTSS score (OR=1.95, CI: 1.18-3.23, P=0.01) and prior CVD history (OR=1.65, CI:1.00-2.73, P=0.05) were found significant predictors of myocardial injury in regression analysis.
UNASSIGNED: Almost one third of hospitalized patients had evidence of acute myocardial injury during hospitalization. Acute myocardial injury is associated with higher hospital and ICCU stay, mortality, higher in-hospital infection which indicates more severe disease and the poor in-hospital outcomes.