Myocardial Injury Is Associated with Higher Morbidity and Mortality in Patients with 2019 Novel Coronavirus Disease (COVID-19)

COVID-19 pandemic, a global health disaster, has resulted in substantial morbidity and mortality across the globe since emerging on December 2019. Studies have shown that cardiovascular manifestations and complications linked to COVID-19 can be attributed to unfavorable clinical outcome and poor prognosis. Adult patients with laboratory-confirmed COVID-19 requiring hospitalization in participating centers between March and June 2020 were included. Data including demographics, laboratory findings, comorbidities, treatments and interventions were collected. Mortality and clinical outcomes in patients with and without cardiac injury were compared. A total of 143 hospitalized patients with confirmed COVID-19 were included (86.7% male; age 49.36 ± 15.32 years). Cardiovascular diseases (CVDs) including hypertension, cardiomyopathy, coronary heart disease, and rhythm disturbances were noted in 34.3% of the study population and 21.7% had cardiac injury. In comparison with patients without cardiac injury, patients with cardiac injury were older (59 [33–89] vs 47 [22–94] years; P < 0.0001) and had more co-morbidities and cardiovascular (CV) risk factors (hypertension in 61.3% vs 24.1%; P < 0.0001, chronic heart failure in 16.1% vs 0%; P < 0.00001, diabetes mellitus 54.8% vs 31.3%; P 0.015, COPD/asthma 19.4% vs 3.6%; P 0.002); more patients with cardiac injury required invasive mechanical ventilation (77.4% vs 38.4%; P 0.00012). Complications were more prevalent in patients with cardiac injury than those without cardiac injury and included acute respiratory distress syndrome (87% vs 42.9%; P < 0.00001), acute kidney injury (67.7% vs 11.6%; P < 0.00001), and anemia (38.7% vs 3.6%;P < 0.00001). The need for renal replacement therapy was also higher in patients with cardiac injury (48.4% vs 3.6%; P < 0.00001). Noticeably, patients with cardiac injury had higher mortality than those without cardiac injury (53.3% vs 7.1%; P < 0.00001). In summary, myocardial injury is common among hospitalized patients with COVID-19 in Oman in relation to older patients with more CV risk factors and comorbidities, and is associated with higher risk of in-hospital mortality and unfavorable clinical outcomes.