Risk Factors and Patterns of Myocardial Injury in Patients with COVID-19: A Single-Centre Cohort Study

Abstract

Objective: The primary objective was to compare the risk factors and trends of patients with COVID-19 with and without biochemical evidence of myocardial injury. Secondary objectives were the duration of hospitalisation, admission to an intensive care unit, mode of resuscitation, and use of supplemental O2. Design, and place and duration of study: This retrospective cohort study was conducted at Shifa International Hospitals, Islamabad, Pakistan. The study was conducted from May 2021–May 2022. Methodology: 113 patients admitted with a confirmed diagnosis of COVID-19 and troponin-I investigation were included in the study. Patients were divided into two groups: with and without myocardial injury on admission. Demographics, symptoms, diagnostics, vitals, comorbidities, and outcomes were noted. The χ2 exact test for categorical variables and independent t-test for continuous variables were used. All statistical analyses were performed with SPSS Statistics®, version 26.0 (IBM®, Armonk, New York, USA), with 0.05 as a level of significance. Results: Out of 113 patients, 47 patients (42%) had no myocardial injury on admission. The mean age of the patients was 63 years. Patients with myocardial injury were older, male, and unvaccinated against COVID-19 (p<0.01). No vital signs or presenting symptoms were statistically significant for myocardial injury. A comorbidity of hypertension on admission was suggestive of myocardial damage. Patients with myocardial injury had a higher risk of requiring resuscitation by cardiopulmonary resuscitation or pharmacologic means. Conclusion: Patients with myocardial injury did not have any impact on the composite of secondary outcomes, such as the duration of hospitalisation, admission to an intensive care unit, and use of supplemental O2.