Implications of myocardial injury in Mexican hospitalized patients with coronavirus disease 2019 (COVID-19)
Aquino Bruno Heberto, Plata Corona Juan Carlos, Castro Rubio José Antonio, Pulido Pérez Patricia, Torres Rasgado Enrique, Morales Portano Julieta Danira, Gómez Álvarez Enrique Benito, Merino Rajme José Alfredo
IJC Heart & Vasculature, doi:10.1016/j.ijcha.2020.100638
Background: Respiratory illnesses is the most common manifestation of Coronavirus disease 2019 (COVID-19); however, myocardial injury has recently emerged as a frequent complication. Methods: An observational, longitudinal, prospective, and multicenter study of hospitalized Mexican patients was made. We assessed the prevalence of myocardial injury and its relationship with complications and mortality. Results: 254 COVID-19 patients were included. Their average age was 53.8 years old, 167 (65.7%) were male and 87 (34.3%) female. According to troponin levels, two populations were generated, those with and without myocardial injury. There was no difference in gender or age between both groups. However, there was a greater proportion of obesity and hypertension in myocardial injury group. Multivariate logistic regression analysis revealed that obesity (OR 2.029, 95% CI 1.039-3.961; p = 0.038), arterial oxygen saturation <90% (OR 2.250, 95% CI 1.216-3.560; p = 0.025), and systolic blood pressure <90 mmHg (OR 2.636, 95% CI 1.530-4.343; p = 0.042), were directly related to higher levels of troponins. Multivariate cox proportional hazards analysis showed that primary endpoint (mortality) was determined by overweight/obesity (OR 1.290, 95% CI 0.115-0.730; p = 0.009), ferritin levels (OR 1.001, 95% CI 1.000-1.001; p < 0.001), myocardial injury (OR 3.764, 95% CI 1.307-10.838; p = 0.014), septic shock (OR 4.104,; p = 0.024), acute respiratory distress syndrome (OR 3.001, 95% CI 1.008-10.165; p = 0.040), and treatment with Hydroxychloroquine/Azithromycin (OR 0.357, 95% IC 0.133-0.955; p = 0.040). Secondary endpoint (Mechanical ventilation risk) was associated to the same factors. Conclusions: Myocardial injury represents an increased risk of complications and death in Mexican hospitalized patients with COVID-19.
CRediT authorship contribution statement Aquino Bruno Heberto: Conceptualization, Methodology, Validation, Investigation, Formal analysis, Writing -original draft, Writing -review & editing, Visualization, Supervision, Project
Declaration of Competing Interest The authors report no relationships that could be construed as a conflict of interest.
Author's contributions and consent for publication As the corresponding author, I declare that all authors in this paper contribute substantially in the work design, analysis, data interpretation, drafting, and intellectual content. Finally all authors approved this version to be published. Author's agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Manuscript We declare this manuscript has not been published before; that it is not under consideration for publication anywhere else; that its publication has been approved by all co-authors, if any, as well as by the responsible authorities -tacitly or explicitly -at the institute where the work has been carried out. The publisher will not be held legally responsible should there be any claims for compensation.
Ethics approval This research was approved by bioethics committee of hospitals involved. We certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later..
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