Abstract

Cardiac damage in non-severe patients with coronavirus disease 2019 (COVID-19) is poorly explored. This study aimed to explore the manifestations of cardiac damage at presentation in non-severe patients with COVID-19. In this study, 113 non-severe patients with COVID-19 were grouped according to the duration from symptoms onset to hospital admission: group 1 (≤ 1 week, n = 27), group 2 (> 1 to 2 weeks, n = 28), group 3 (> 2 to 3 weeks, n = 27), group 4 (> 3 weeks, n = 31). Clinical, cardiovascular, and radiological data on hospital admission were compared across the four groups. The level of high sensitivity troponin I (hs-cTnI) in group 2 [10.25 (IQR 6.75–15.63) ng/L] was significantly higher than those in group 1 [1.90 (IQR 1.90–8.80) ng/L] and group 4 [1.90 (IQR 1.90–5.80) ng/L] (all Pbonferroni < 0.05). The proportion of patients who had a level of hs-cTnI ≥ 5 ng/L in group 2 (85.71%) was significantly higher than those in the other three groups (37.04%, 51.85%, and 25.81%, respectively) (all Pbonferroni < 0.05). Compared with patients with hs-cTnI under 5 ng/L, those with hs-cTnI ≥ 5 ng/L had lower lymphocyte count (P = 0.000) and SpO2 (P = 0.002) and higher CRP (P = 0.000). Patients with hs-cTnI ≥ 5 ng/L had a higher incidence of bilateral pneumonia (P = 0.000) and longer hospital length of stay (P = 0.000). In conclusion, non-severe patients with COVID-19 in the second week after symptoms onset were most likely to suffer cardiac damage. A detectable level of hs-cTnI ≥ 5 ng/L might be a manifestation of early cardiac damage in the patients.

Highlights

  • Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARSCov-2), has impacted health globally on an unprecedented scale, and the number of cases continues to rise ­worldwide[1]

  • The cardiac involvement, which was revealed by cardiovascular magnetic resonance, was reported in 78% of COVID-19 patients (78/100), whereas only 5% of these patients presented a higher level of hs-cTnI than the 99th ­percentile[11]

  • All these results indicated that cardiac injury might be the tip of the iceberg in the cardiac damage of COVID-19

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Summary

Introduction

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARSCov-2), has impacted health globally on an unprecedented scale, and the number of cases continues to rise ­worldwide[1]. The cardiac involvement, which was revealed by cardiovascular magnetic resonance, was reported in 78% of COVID-19 patients (78/100), whereas only 5% of these patients presented a higher level of hs-cTnI than the 99th ­percentile[11]. All these results indicated that cardiac injury might be the tip of the iceberg in the cardiac damage of COVID-19. We hypothesized that a higher level of hs-cTnI than 5 ng/L is one of the manifestations of cardiac damage in non-severe patients COVID-19 To verify this hypothesis, this study aimed to investigate the manifestations of cardiac damage at presentation in non-severe patients with COVID-19

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