tetano
Editor, Senior Moderator
J Clin Med
. 2021 May 13;10(10):2096.
doi: 10.3390/jcm10102096.
Myocardial Injury in COVID-19 Patients: Association with Inflammation, Coagulopathy and In-Hospital Prognosis
Victor Arévalos[SUP] 1 2 [/SUP], Luis Ortega-Paz[SUP] 1 2 [/SUP], Juan José Rodríguez-Arias[SUP] 1 2 [/SUP], Margarita Calvo[SUP] 1 [/SUP], Leticia Castrillo[SUP] 1 [/SUP], Anthony Salazar[SUP] 1 [/SUP], Merce Roque[SUP] 1 2 [/SUP], Ana Paula Dantas[SUP] 2 [/SUP], Manel Sabaté[SUP] 1 2 [/SUP], Salvatore Brugaletta[SUP] 1 2 [/SUP]
Affiliations
Abstract
The exact mechanisms leading to myocardial injury in the coronavirus disease 2019 (COVID-19) are still unknown. In this retrospective observational study, we include all consecutive COVID-19 patients admitted to our center. They were divided into two groups according to the presence of myocardial injury. Clinical variables, Charlson Comorbidity Index (CCI), C-reactive protein (CRP), CAC (COVID-19-associated coagulopathy), defined according to the ISTH score, treatment and in-hospital events were collected. Between March and April 2020, 331 COVID-19 patients were enrolled, 72 of them (21.8%) with myocardial injury. Patients with myocardial injury showed a higher CCI score (median (interquartile range), 5 (4-7) vs. 2 (1-4), p = 0.001), higher CRP values (18.3 (9.6-25.9) mg/dL vs. 12.0 (5.4-19.4) mg/dL, p ˂ 0.001) and CAC score (1 (0-2) vs. 0 (0-1), p = 0.001), and had lower use of any anticoagulant (57 patients (82.6%) vs. 229 patients (90.9%), p = 0.078), than those without. In the adjusted logistic regression, CRP, myocardial injury, CCI and CAC score were positive independent predictors of mortality, whereas anticoagulants resulted as a protective factor. Myocardial injury in COVID-19 patients is associated with inflammation and coagulopathy, resulting in a worse in-hospital prognosis. Treatment with anticoagulant agents may help to improve in-hospital outcomes.
Keywords: coagulopathy; coronavirus disease 2019; mortality; myocardial injury.
. 2021 May 13;10(10):2096.
doi: 10.3390/jcm10102096.
Myocardial Injury in COVID-19 Patients: Association with Inflammation, Coagulopathy and In-Hospital Prognosis
Victor Arévalos[SUP] 1 2 [/SUP], Luis Ortega-Paz[SUP] 1 2 [/SUP], Juan José Rodríguez-Arias[SUP] 1 2 [/SUP], Margarita Calvo[SUP] 1 [/SUP], Leticia Castrillo[SUP] 1 [/SUP], Anthony Salazar[SUP] 1 [/SUP], Merce Roque[SUP] 1 2 [/SUP], Ana Paula Dantas[SUP] 2 [/SUP], Manel Sabaté[SUP] 1 2 [/SUP], Salvatore Brugaletta[SUP] 1 2 [/SUP]
Affiliations
- PMID: 34068127
- DOI: 10.3390/jcm10102096
Abstract
The exact mechanisms leading to myocardial injury in the coronavirus disease 2019 (COVID-19) are still unknown. In this retrospective observational study, we include all consecutive COVID-19 patients admitted to our center. They were divided into two groups according to the presence of myocardial injury. Clinical variables, Charlson Comorbidity Index (CCI), C-reactive protein (CRP), CAC (COVID-19-associated coagulopathy), defined according to the ISTH score, treatment and in-hospital events were collected. Between March and April 2020, 331 COVID-19 patients were enrolled, 72 of them (21.8%) with myocardial injury. Patients with myocardial injury showed a higher CCI score (median (interquartile range), 5 (4-7) vs. 2 (1-4), p = 0.001), higher CRP values (18.3 (9.6-25.9) mg/dL vs. 12.0 (5.4-19.4) mg/dL, p ˂ 0.001) and CAC score (1 (0-2) vs. 0 (0-1), p = 0.001), and had lower use of any anticoagulant (57 patients (82.6%) vs. 229 patients (90.9%), p = 0.078), than those without. In the adjusted logistic regression, CRP, myocardial injury, CCI and CAC score were positive independent predictors of mortality, whereas anticoagulants resulted as a protective factor. Myocardial injury in COVID-19 patients is associated with inflammation and coagulopathy, resulting in a worse in-hospital prognosis. Treatment with anticoagulant agents may help to improve in-hospital outcomes.
Keywords: coagulopathy; coronavirus disease 2019; mortality; myocardial injury.