Abstract
Novel coronavirus disease (COVID-19) has led to a major public health crisis globally. Currently, myocardial damage is speculated to be associated with COVID-19, which can be seen as one of the main causes of death of patients with COVID-19. We therefore, aim to investigate the effects of COVID-19 disease on myocardial injury in hospitalized patients who have been tested positive for COVID-19 pneumonia in this study. A prospective study was conducted among 201 patients with COVID-19 in the Pakistan Military Hospital from April 1 to August 31, 2020, including non-critical cases and critical cases. COVID-19 patients were stratified as critical and non-critical according to the signs and symptoms severity; with those requiring intensive care and invasive mechanical ventilation as critical, and those did not requiring invasive mechanical ventilation as non-critical. A total of 201 COVID-19 patients with critical and non-critical categories presented with myocardial injury. All patients with myocardial injury had an elevation in CKMB and Troponin-I levels. Of these patients, 43.7% presented with new electrocardiography (ECG) changes, and ST depression was typically observed in 36.3% patients. In addition, 18.7% patients presented with abnormal echocardiography findings, with right ventricular dilatation and dysfunction commonly seen among critical group patients. Results analyzed by a logistic regression model showing COVID-19 direct contribution to myocardial injury in these patients. COVID-19 disease directly leads to cardiovascular damage among critical and non-critical patients. Myocardial injury is associated not only with abnormal ECG changes but also with myocardial dysfunction on echocardiography and more commonly observed among critical patients.
Highlights
Novel coronavirus disease (COVID-19) has led to a major public health crisis globally
We aimed to investigate the myocardial injury patterns, ECG changes, echocardiographic parameters in COVID-19 diagnosed patients of critical and non-critical categories in Pakistan’s largest tertiary care center
COVID-19 disease is associated with multi-system involvement including the cardiovascular system
Summary
Novel coronavirus disease (COVID-19) has led to a major public health crisis globally. There is insufficient evidence available to resolve any specific threats of COVID-19 induced myocardial injury This awareness is of paramount importance to understand the risk for direct and indirect adverse effects of the SARS-CoV-2 on the heart, in those with already existing heart disease. We aimed to investigate the myocardial injury patterns, ECG changes, echocardiographic parameters in COVID-19 diagnosed patients of critical and non-critical categories in Pakistan’s largest tertiary care center. These results will provide updated information for physicians to improve the survival of people with COVID-19
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