Evaluation of myocardial injury patterns and ST changes among critical and non-critical patients with coronavirus-19 disease

Sci Rep. 2021 Mar 1;11(1):4828. doi: 10.1038/s41598-021-84467-4.

Abstract

Novel coronavirus disease (COVID-19) has led to a major public health crisis globally. Currently, myocardial damage is speculated to be associated with COVID-19, which can be seen as one of the main causes of death of patients with COVID-19. We therefore, aim to investigate the effects of COVID-19 disease on myocardial injury in hospitalized patients who have been tested positive for COVID-19 pneumonia in this study. A prospective study was conducted among 201 patients with COVID-19 in the Pakistan Military Hospital from April 1 to August 31, 2020, including non-critical cases and critical cases. COVID-19 patients were stratified as critical and non-critical according to the signs and symptoms severity; with those requiring intensive care and invasive mechanical ventilation as critical, and those did not requiring invasive mechanical ventilation as non-critical. A total of 201 COVID-19 patients with critical and non-critical categories presented with myocardial injury. All patients with myocardial injury had an elevation in CKMB and Troponin-I levels. Of these patients, 43.7% presented with new electrocardiography (ECG) changes, and ST depression was typically observed in 36.3% patients. In addition, 18.7% patients presented with abnormal echocardiography findings, with right ventricular dilatation and dysfunction commonly seen among critical group patients. Results analyzed by a logistic regression model showing COVID-19 direct contribution to myocardial injury in these patients. COVID-19 disease directly leads to cardiovascular damage among critical and non-critical patients. Myocardial injury is associated not only with abnormal ECG changes but also with myocardial dysfunction on echocardiography and more commonly observed among critical patients.

Publication types

  • Clinical Trial
  • Observational Study

MeSH terms

  • Adult
  • COVID-19* / blood
  • COVID-19* / complications
  • COVID-19* / physiopathology
  • COVID-19* / therapy
  • Critical Care
  • Echocardiography*
  • Electrocardiography*
  • Female
  • Heart Injuries* / blood
  • Heart Injuries* / etiology
  • Heart Injuries* / physiopathology
  • Heart Injuries* / therapy
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Myocardium / metabolism
  • Prospective Studies
  • SARS-CoV-2 / metabolism*
  • Severity of Illness Index