Abstract
Cardiac injury is associated with poor prognosis of 2019 novel coronavirus disease 2019 (COVID-19), but the risk factors for cardiac injury have not been fully studied. In this study, we carried out a systematic analysis of clinical characteristics in COVID-19 patients to determine potential risk factors for cardiac injury complicated COVID-19 virus infection. We systematically searched relevant literature published in Pubmed, Embase, Europe PMC, CNKI and other databases. All statistical analyses were performed using STATA 16.0. We analysed 5726 confirmed cases from 17 studies. The results indicated that compared with non-cardiac-injured patients, patients with cardiac injury are older, with a greater proportion of male patients, with higher possibilities of existing comorbidities, with higher risks of clinical complications, need for mechanical ventilation, ICU transfer and mortality. Moreover, C-reactive protein, procalcitonin, D-dimer, NT-proBNP and blood creatinine in patients with cardiac injury are also higher while lymphocyte counts and platelet counts decreased. However, we fortuitously found that patients with cardiac injury did not present higher clinical specificity for chest distress (P = 0.304), chest pain (P = 0.334), palpitations (P = 0.793) and smoking (P = 0.234). Similarly, the risk of concomitant arrhythmia (P = 0.103) did not increase observably either. Age, male gender and comorbidities are risk factors for cardiac injury complicated COVID-19 infection. Such patients are susceptible to complications and usually have abnormal results of laboratory tests, leading to poor outcomes. Contrary to common cardiac diseases, cardiac injury complicated COVID-19 infection did not significantly induce chest distress, chest pain, palpitations or arrhythmias. Our study indicates that early prevention should be applied to COVID-19 patients with cardiac injury to reduce adverse outcomes.
Highlights
Coronavirus 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) is becoming the primary focus of global health care since December 2019 and there has been 3 267 184 confirmed cases and 229 971 deaths worldwide till 2 May2020 [1]
Male gender and comorbidities are risk factors for cardiac injury complicated COVID-19 infection. Such patients are susceptible to complications and usually have abnormal results of laboratory tests, leading to poor outcomes
Our study indicates that early prevention should be applied to COVID-19 patients with cardiac injury to reduce adverse outcomes
Summary
Coronavirus 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) is becoming the primary focus of global health care since December 2019 and there has been 3 267 184 confirmed cases and 229 971 deaths worldwide till 2 May2020 [1]. Another study revealed that the in-hospital mortality rate of COVID-19 patients with cardiovascular injury reached up to 4.3–28.2% while SARS patients complicated with cardiovascular disease have much lower death rate, around 3.6–. 13% [3], suggesting that abnormal cardiovascular events may have a profound impact on the disease progression and clinical outcome of COVID-19 patients (Fig. 1). Cardiac injury is the basis of most adverse cardiovascular events such as acute myocardial infarction and myocarditis, and a prominent characteristic of COVID-19 patients. It is associated with the severity of the disease and the risk of mortality [4, 5].
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