Early vs. Late Onset Cardiac Injury and Mortality in Hospitalized COVID-19 Patients in Wuhan
oleh: Wei Sun, Wei Sun, Wei Sun, Yanting Zhang, Yanting Zhang, Yanting Zhang, Chun Wu, Chun Wu, Chun Wu, Shuyuan Wang, Shuyuan Wang, Shuyuan Wang, Yuji Xie, Yuji Xie, Yuji Xie, Danqing Zhang, Danqing Zhang, Danqing Zhang, Hongliang Yuan, Hongliang Yuan, Hongliang Yuan, Yongxing Zhang, Yongxing Zhang, Yongxing Zhang, Li Cui, Li Cui, Li Cui, Meng Li, Meng Li, Meng Li, Yiwei Zhang, Yiwei Zhang, Yiwei Zhang, Yuman Li, Yuman Li, Yuman Li, Jing Wang, Jing Wang, Jing Wang, Yali Yang, Yali Yang, Yali Yang, Qing Lv, Qing Lv, Qing Lv, Li Zhang, Li Zhang, Li Zhang, Philip Haines, Wen-Chih Wu, Mingxing Xie, Mingxing Xie, Mingxing Xie
| Format: | Article |
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| Diterbitkan: | Frontiers Media S.A. 2021-05-01 |
Deskripsi
Background: Increasing evidence points to cardiac injury (CI) as a common coronavirus disease 2019 (COVID-19) related complication. The characteristics of early CI (occurred within 72 h of admission) and late CI (occurred after 72 h of admission) and its association with mortality in COVID-19 patients is unknown.Methods: This retrospective study analyzed patients confirmed with COVID-19 in Union Hospital (Wuhan, China) from Jan 29th to Mar 15th, 2020. Clinical outcomes (discharge, or death) were monitored to April 15, 2020, the latest date of follow-up. Demographic, clinical, laboratory, as well as treatment and prognosis were collected and analyzed in patients with early, late CI and without CI.Results: A total of 196 COVID-19 patients were included for analysis. The median age was 65 years [interquartile range (IQR) 56–73 years], and 112 (57.1%) were male. Of the 196 COVID-19 patients, 49 (25.0%) patients had early and 20 (10.2%) patients had late CI, 56.6% developed Acute-Respiratory-Distress-Syndrome (ARDS) and 43 (21.9%) patients died. Patients with any CI were more likely to have developed ARDS (87.0 vs. 40.2%) and had a higher in-hospital mortality than those without (52.2 vs. 5.5%, P < 0.001). Among CI subtypes, a significantly higher risk of in-hospital death was found in patients with early CI with recurrence [19/49 patients, adjusted odds ratio (OR) = 7.184, 95% CI 1.472–35.071] and patients with late CI (adjusted OR = 5.019, 95% CI 1.125–22.388) compared to patients with early CI but no recurrence.Conclusions: CI can occur early on or late after, the initial 72 h of admission and is associated with ARDS and an increased risk of in-hospital mortality. Both late CI and recurrent CI after the initial episode were associated with worse outcomes than patients with early CI alone. This study highlights the importance of early examination and periodical monitoring of cardiac biomarkers, especially for patients with early CI or at risk of clinical deterioration.