Abstract
BackgroundCoronavirus disease 2019 (COVID-19) has become a global pandemic. Studies showed COVID-19 affected not only the lung but also other organs. In this study, we aimed to explore the cardiac damage in patients with COVID-19.MethodsWe collected data of 100 patients diagnosed as severe type of COVID-19 from February 8 to April 10, 2020, including demographics, illness history, physical examination, laboratory test, and treatment. In-hospital mortality were observed. Cardiac damage was defined as plasma hypersensitive troponin I (hsTnI) over 34.2 pg/ml and/or N-terminal-pro brain natriuretic peptide (NTproBNP) above 450 pg/ml at the age < 50, above 900 pg/ml at the age < 75, or above 1800 pg/ml at the age ≥ 75.ResultsThe median age of the patients was 62.0 years old. 69 (69.0%) had comorbidities, mainly presenting hypertension, diabetes, and cardiovascular disease. Fever (69 [69.0%]), cough (63 [63.0%]), chest distress (13 [13.0%]), and fatigue (12 [12.0%]) were the common initial symptoms. Cardiac damage occurred in 25 patients. In the subgroups, hsTnI was significantly higher in elder patients (≥ 60 years) than in the young (median [IQR], 5.2 [2.2–12.8] vs. 1.9 [1.9–6.2], p = 0.018) and was higher in men than in women (4.2 [1.9–12.8] vs. 2.9 [1.9–7.4], p = 0.018). The prevalence of increased NTproBNP was significantly higher in men than in women (32.1% vs. 9.1%, p = 0.006), but was similar between the elder and young patients (20.0% vs. 25.0%, p = 0.554). After multivariable analysis, male and hypertension were the risk factors of cardiac damage. The mortality was 4.0%.ConclusionsCardiac damage exists in patients with the severe type of COVID-19, especially in male patients with hypertension. Clinicians should pay more attention to cardiac damage.
Highlights
Since the novel coronavirus–severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) named by the Coronavirus Study Group of the International Committee on Taxonomy of Viruses [1], was discovered in December 2019, it quickly spread throughout China and other countries [2,3,4,5]
Cardiac damage exists in patients with the severe type of COVID-19, especially in male patients with hypertension
Patients were all diagnosed as COVID-19 and classified into the severe type according to the Diagnosis and Treatment of Pneumonia Infected by Novel Coronavirus (5th trial edition) pressed by the General Office of the National Health Commission and the General Office of the National Administration of Traditional Chinese Medicine [7]
Summary
Since the novel coronavirus–severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) named by the Coronavirus Study Group of the International Committee on Taxonomy of Viruses [1], was discovered in December 2019, it quickly spread throughout China and other countries [2,3,4,5]. As of April 30, 2020, SARS-CoV-2 has broken out in 213 countries, areas and territories with 3,090,445 confirmed cases and 217,769 deaths [6]. Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 could be classified into four clinical types: mild, moderate, severe and critical types [7]. More than 80% are mild or moderate with relatively good short-term prognosis due to the self-limiting process according to the study with 44,672 confirmed COVID-19 cases released by the Chinese. Researchers have reported that patients with COVID19 had acute cardiac injury, which is associated with a higher risk of in-hospital mortality [4, 9, 10]. Studies focusing on cardiac damage in patients with the severe COVID-19 are few. We aimed to explore the cardiac damage in patients with COVID-19
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