Abstract
Background: Cardiac injury is common and associated with poor clinical outcomes in COVID-19. Data are lacking whether high-dose intravenous vitamin C (HIVC) could help to ameliorate myocardial injury in the pandemic.Methods: The retrospective cohort study included consecutive severe and critically ill COVID-19 patients with cardiac injury receiving symptomatic supportive treatments alone or together with HIVC. Troponin I and inflammatory markers were collected at admission and day 21 during hospitalization from the electronic medical records.Results: The patients (n = 113) were categorized into the ameliorated cardiac injury (ACI) group (n = 70) and the non-ameliorated cardiac injury (NACI) group (n = 43). Overall, fifty-one (45.1%) patients were administered with HIVC, the percentages of patients with HIVC were higher in the ACI group than those in the NACI group. Logistic regression analysis revealed that HIVC was independently associated with the improvement of myocardial injury. Further analysis showed that inflammatory markers levels significantly decreased at day 21 during hospitalization in patients with HIVC therapy compared to those administered with symptomatic supportive treatments alone. Meanwhile, similar results were also observed regarding changes in inflammatory markers levels from baseline to day 21 during hospitalization in the patients treated with HIVC.Conclusions: HIVC can ameliorate cardiac injury through alleviating hyperinflammation in severe and critically ill patients with COVID-19.
Highlights
Coronavirus disease 2019 (COVID-19) caused by a novel coronavirus named SARS-CoV-2 poses a worldwide healthcare issue with the increasing number of infected individuals [1]
The study subjects consisted of COVID-19 pneumonia with myocardial damage who consecutively admitted to Tongji Hospital of Huazhong University of Science and Technology (Wuhan, China), and were diagnosed as positive for SARS-CoV-2 infection by performing RTPCR assay on samples from nasal and pharyngeal swab, and were in severe and critically ill condition
A total of 113 confirmed COVID-19 cases were included in the study: 70 in the ameliorated cardiac injury (ACI) group and 43 in the non-ameliorated cardiac injury (NACI) group
Summary
Coronavirus disease 2019 (COVID-19) caused by a novel coronavirus named SARS-CoV-2 poses a worldwide healthcare issue with the increasing number of infected individuals [1]. The result of a recent report has shown that myocardial damage is a very common issue with increased risk of poor clinical prognosis in the course of severe cases [2]. A growing body of evidence revealed that patients with severe illness might have a high inflammatory burden, which predicted adverse clinical events in individuals suffering from COVID-19 infection; in patients in case of cardiac www.aging-us.com injury [2, 4]. Further analysis showed that inflammatory markers levels significantly decreased at day 21 during hospitalization in patients with HIVC therapy compared to those administered with symptomatic supportive treatments alone. Conclusions: HIVC can ameliorate cardiac injury through alleviating hyperinflammation in severe and critically ill patients with COVID-19
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