1-year mortality after myocardial injury in COVID-19 patients

Abstract

Abstract Background Myocardial injury is a known complication of COVID-19 and is related to a worse prognosis on admission. However, its impact on 1-year mortality is unknown. Methods Retrospective cohort study with patients admitted to intensive care and confirmed diagnosis of COVID-19 by RT-PCR and with at least one measurement of troponin during hospitalization. The study period was from March/2020 to June/2021. Clinical characteristics and the occurrence of myocardial were assessed between deaths and survivors using the chi-square test and Student's t-test. Variables with p<0.01 in the univariate analysis were included in the Cox regression model to identify predictor variables of 1-year mortality. Results 1037 patients were included, with a mean follow-up of 1.06±0.58 years, mean age = 59.9±16.2 years, and 62.7% men. The prevalence of myocardial injury was 42.8% and occurred 204 deaths (19.7%). In the univariate analysis, the variables associated with 1-year mortality were: myocardial injury (OR 7.5; CI95% 5.2–10.9), age >60 years (OR 5.65; CI95% 3.9–8.2), arterial hypertension (OR 2.8; CI95% 2.0–3.9), diabetes (OR 2.3; CI95% 1.6–3.1), chronic kidney failure (OR 3.9; CI95% 2.2–6.8), dementia (OR 1.8; CI95% 1.2–2.6) and mechanical ventilation (OR 50.5; CI95% 33.9–77.3). In Cox regression, the predictor variables were: myocardial injury (HR 2.4; CI95% 1.7–3.5), age >60 years (HR 2.5; CI95% 1.8–3.6), chronic kidney disease (HR 1.9; CI95% 1.2–2.9), dementia (HR 3.2; CI95% 2.1–5.0) and mechanical ventilation (HR 17.5; CI95% 12.2–25.2). Conclusion In patients admitted to intensive care by COVID-19, the detection of myocardial injury more than doubled the risk of death in 1 year. Funding Acknowledgement Type of funding sources: None.