Incidence of New-Onset Cardiac Complications among requiring Invasive Mechanical Ventilation: Findings from a Retrospective Cohort Study

Abstract

Background: COVID-19 patients are prone to develop many systemic complications including cardiac complications. Objective: This study aimed to determine the overall incidence of new-onset cardiac complications among patients admitted to COVID ICU and the possible role of cardiac complications in deciding the length of hospital or ICU stay and ICU mortality. Methods: A retrospective observational study was conducted among critically ill COVID-19 patients admitted to the ICU of Aga Khan University Hospital in Karachi, Pakistan from June 2020 to May 2021. Medical Records of 159 adult COVID-ICU patients with no prior history of cardiac illness admitted between June 2020 till May 2021, were analyzed. Results: The median age of COVID-ICU patients was 58 years (IQR =17 years). 48.4% (n=77) of all COVID-ICU patients developed one or more new cardiac events, with an incidence density of 92.9/1000 patient-days of COVID-ICU stays. Non-ST elevation myocardial infarction, ECG changes, and cardiac arrhythmias were identified as the most common cardiac complications. The study found a significantly higher frequency of cardiac events among patients having Diabetes Mellitus and Septic Shock. The study also found significant differences in ICU and hospital mortality among COVID-ICU patients with and without cardiac complications. Conclusion: The incidence of cardiac complications is considerably high among COVID-ICU patients and is relatively higher among patients having Diabetes Mellitus and septic shock. Patients with cardiac complications showed considerably higher ICU and hospital mortality. Early identification of patients at higher risk of cardiac complications is crucial for better management of critically ill COVID-19 patients.