Abstract 15633: Clinical Features and Prognosis of Acute Cardiac Injury in Hospitalized Patients With Covid-19: A Retrospective Cohort Study

Abstract

Background: The number of fatalities due to coronavirus disease 2019 (COVID-19) is escalating. However, information on critical complications in hospitalized patients of COVID-19 is scant. We aimed to explore the prevalence of acute cardiac injury and its association with in-hospital mortality in COVID-19 patients. Method: This retrospective study analyzed patients confirmed with COVID-19 in Union Hospital (Wuhan, China) from Jan 24 to March 18, 2020. Clinical outcomes (discharge, or death) were monitored to April 9, 2020, the latest date of follow-up. Demographic, clinical, laboratory, echocardiographic data as well as treatment and prognosis were analyzed. Comparisons were made between patients with acute cardiac injury and those without. An association of acute cardiac injury and in-hospital mortality was identified. Results: A total of 235 COVID-19 patients were included in the final analysis. Their median age was 66 years (interquartile range 57 - 73 years), and 131 (55.7%) were men. 98 (41.7%) patients were diagnosed with acute cardiac injury, of whom 60 (61.2%) died. There were more comorbidities in those who had acute cardiac injury than those who did not have. A higher proportion of patients with acute cardiac injury received glucocorticoid therapy (68.0% vs 37.0%; P < 0.001), immunoglobulin (53.1% vs 30.1%; P < 0.001), high-flow oxygen (79.6% vs 43.1%; P < 0.001), and invasive mechanical ventilation (40.8% vs 6.6%; P < 0.001) than those without acute cardiac injury. The percentage of patients who were admitted to intensive care unit (39.8 % vs 8.0%; P < 0.001) or died during hospitalization (61.2% vs 8.0%, P < 0.001) were also higher in those with acute cardiac injury. Plasma high-sensitivity troponin I levels correlated significantly with plasma interleukin -6, procalcitonin and C-reactive protein levels in COVID-19 patients. Echocardiography showed the cardiac function was attenuated in acute cardiac injury patients. Multivariable Cox proportional hazards regression analysis showed acute cardiac injury was an independent risk factor for higher in-hospital mortality in COVID-19 patients (HR, 3.393; 95% CI, 1.647- 6.987, P <0.001).