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. 2020 Jun 24;48(6):461-466.
doi: 10.3760/cma.j.cn112148-20200313-00202.

[Prognostic value of myocardial injury in patients with COVID-19]

[Article in Chinese]
L Wang  1 , W B He  1 , X M Yu  1 , H F Liu  1 , W J Zhou  1 , H Jiang  1
Affiliations

[Prognostic value of myocardial injury in patients with COVID-19]

[Article in Chinese]
L Wang et al. Zhonghua Xin Xue Guan Bing Za Zhi. .

Abstract
in English, Chinese

Objective: To analyze the prognostic value of myocardial injury in patients with COVID-19. Method: Confirmed cases of COVID-19 patients admitted from January 31st to February 5th at isolation ward of Renmin Hospital of Wuhan University were divided into non-survival group （33 cases）and survival group (169 cases)according to the clinical outcomes 5 weeks after admission. Data including demographics, comorbidities, vital signs, laboratory results were obtained. Cardiac injury was defined as serum concentration of high sensitivity cardiac troponin I (hs-cTnI) above 0.04 μg/L. Univariate and multivariate Cox regression were used to analyze the prognostic value of myocardial injury in patients with COVID-19. Kaplan-Meier analysis was used to plotted survival curve and analyze the impact of myocardial injury on the survival outcome of COVID-19 patients. Results: A total of 202 patients were included, the age was 63 (51, 70) years old, 88 (43.6%) of them were male, 85 (42.1%) of them had comorbidities, 125 (61.9%) of them were severely to critically ill. Till March 11, 33 patients died, all of them were critically ill patients. The age, proportion of males, comorbidities, respire rate, serum levels of hs-cTnI and incidence of heart failure in the non-survival group were significantly higher than those in the survival group (all P<0.05). The hospitalization time of non-survival group was significantly shorter than that of survival group (6(4, 9) vs. 32(23, 36), P<0.001). Myocardial injury was an important prognostic factor of COVID-19 (HR=5.382, 95%CI 2.404-12.050, P<0.001). Kaplan-Meier survival analysis showed that the presence of myocardial injury was significantly associated with the reduced survival rate among COVID-19 patients (P<0.001). Conclusion: Myocardial injury is an important prognostic factor of COVID-19, COVID-19 patients with myocardial injury face a significantly higher risk of death.

目的： 分析心肌损伤对新型冠状病毒肺炎（COVID-19）患者临床预后的影响。 方法： 回顾性分析2020年1月31日至2月5日在武汉大学人民医院入院确诊为COVID-19患者，根据入院5周后的临床转归，分为死亡组（33例）和生存组（169例），分析两组患者的人口统计学、合并症、入院生命体征和实验室检查结果。心肌损伤界定为血清超敏心肌肌钙蛋白I（hs-cTnI）水平>0.04 μg/L。采用单因素和多因素Cox回归分析COVID-19患者临床预后的预测因素，采用Kaplan-Meier生存曲线比较心肌损伤和无心肌损伤患者的生存率。 结果： 共纳入202例患者，年龄为63(51，70)岁，其中男性88例（43.6%），85例（42.1%）患者具有临床合并症，125例（61.9%）为重型/危重型患者。截至3月11日死亡33例，全部为危重型患者。死亡组患者年龄、男性及合并基础病比例、呼吸频率、入院时hs-cTnI水平以及心功能不全发生率均高于生存组（P均<0.05）。死亡组住院时间显著短于生存组[6（4，9）d比32（23，36）d，P<0.001]。多因素Cox回归分析显示，心肌损伤是COVID-19患者临床预后的重要预测因子（HR=5.382，95%CI 2.404~12.050，P<0.001）。Kaplan-Meier生存分析显示心肌损伤患者的生存率明显低于无心肌损伤患者（P<0.001）。 结论： 心肌损伤是新型冠状病毒肺炎患者临床预后的重要预测因子，发生了心肌损伤的患者面临更高的死亡风险。.

Keywords: COVID-19; Cardiac insufficiency; Cardiac troponin; Myocardial injury; Prognosis.

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