Abstract
Background
The degree of myocardial injury, as reflected by troponin elevation, and associated outcomes among U.S. hospitalized patients with coronavirus disease-2019 (COVID-19) are unknown.
Objectives
The purpose of this study was to describe the degree of myocardial injury and associated outcomes in a large hospitalized cohort with laboratory-confirmed COVID-19.
Methods
Patients with COVID-19 admitted to 1 of 5 Mount Sinai Health System hospitals in New York City between February 27, 2020, and April 12, 2020, with troponin-I (normal value <0.03 ng/ml) measured within 24 h of admission were included (n = 2,736). Demographics, medical histories, admission laboratory results, and outcomes were captured from the hospitals’ electronic health records.
Results
The median age was 66.4 years, with 59.6% men. Cardiovascular disease (CVD), including coronary artery disease, atrial fibrillation, and heart failure, was more prevalent in patients with higher troponin concentrations, as were hypertension and diabetes. A total of 506 (18.5%) patients died during hospitalization. In all, 985 (36%) patients had elevated troponin concentrations. After adjusting for disease severity and relevant clinical factors, even small amounts of myocardial injury (e.g., troponin I >0.03 to 0.09 ng/ml; n = 455; 16.6%) were significantly associated with death (adjusted hazard ratio: 1.75; 95% CI: 1.37 to 2.24; p < 0.001) while greater amounts (e.g., troponin I >0.09 ng/dl; n = 530; 19.4%) were significantly associated with higher risk (adjusted HR: 3.03; 95% CI: 2.42 to 3.80; p < 0.001).
Conclusions
Myocardial injury is prevalent among patients hospitalized with COVID-19; however, troponin concentrations were generally present at low levels. Patients with CVD are more likely to have myocardial injury than patients without CVD. Troponin elevation among patients hospitalized with COVID-19 is associated with higher risk of mortality.
【저자키워드】 COVID-19, coronavirus, troponin, myocardial injury, 【초록키워드】 Hospitalized, Mortality, Hospitalization, disease severity, hospital, diabetes, outcome, hypertension, New York City, cardiovascular, Coronary artery disease, heart failure, Atrial fibrillation, Cohort, Laboratory results, Patient, death, troponin I, disease, Admission, Concentration, Injury, Electronic health records, Mount Sinai, CVD, higher risk, median age, clinical factors, laboratory-confirmed, men, System, objective, concentrations, prevalent, Result, greater, significantly, elevated, adjusted, reflected, hospitalized patient, patients died, patients hospitalized, with COVID-19, 【제목키워드】 Impact,