Cargando…
Myocardial Injury in COVID-19 Patients: Association with Inflammation, Coagulopathy and In-Hospital Prognosis
The exact mechanisms leading to myocardial injury in the coronavirus disease 2019 (COVID-19) are still unknown. In this retrospective observational study, we include all consecutive COVID-19 patients admitted to our center. They were divided into two groups according to the presence of myocardial in...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8152726/ https://www.ncbi.nlm.nih.gov/pubmed/34068127 http://dx.doi.org/10.3390/jcm10102096 |
_version_ | 1783698655026348032 |
---|---|
author | Arévalos, Victor Ortega-Paz, Luis Rodríguez-Arias, Juan José Calvo, Margarita Castrillo, Leticia Salazar, Anthony Roque, Merce Dantas, Ana Paula Sabaté, Manel Brugaletta, Salvatore |
author_facet | Arévalos, Victor Ortega-Paz, Luis Rodríguez-Arias, Juan José Calvo, Margarita Castrillo, Leticia Salazar, Anthony Roque, Merce Dantas, Ana Paula Sabaté, Manel Brugaletta, Salvatore |
author_sort | Arévalos, Victor |
collection | PubMed |
description | The exact mechanisms leading to myocardial injury in the coronavirus disease 2019 (COVID-19) are still unknown. In this retrospective observational study, we include all consecutive COVID-19 patients admitted to our center. They were divided into two groups according to the presence of myocardial injury. Clinical variables, Charlson Comorbidity Index (CCI), C-reactive protein (CRP), CAC (COVID-19-associated coagulopathy), defined according to the ISTH score, treatment and in-hospital events were collected. Between March and April 2020, 331 COVID-19 patients were enrolled, 72 of them (21.8%) with myocardial injury. Patients with myocardial injury showed a higher CCI score (median (interquartile range), 5 (4–7) vs. 2 (1–4), p = 0.001), higher CRP values (18.3 (9.6–25.9) mg/dL vs. 12.0 (5.4–19.4) mg/dL, p ˂ 0.001) and CAC score (1 (0–2) vs. 0 (0–1), p = 0.001), and had lower use of any anticoagulant (57 patients (82.6%) vs. 229 patients (90.9%), p = 0.078), than those without. In the adjusted logistic regression, CRP, myocardial injury, CCI and CAC score were positive independent predictors of mortality, whereas anticoagulants resulted as a protective factor. Myocardial injury in COVID-19 patients is associated with inflammation and coagulopathy, resulting in a worse in-hospital prognosis. Treatment with anticoagulant agents may help to improve in-hospital outcomes. |
format | Online Article Text |
id | pubmed-8152726 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-81527262021-05-27 Myocardial Injury in COVID-19 Patients: Association with Inflammation, Coagulopathy and In-Hospital Prognosis Arévalos, Victor Ortega-Paz, Luis Rodríguez-Arias, Juan José Calvo, Margarita Castrillo, Leticia Salazar, Anthony Roque, Merce Dantas, Ana Paula Sabaté, Manel Brugaletta, Salvatore J Clin Med Article The exact mechanisms leading to myocardial injury in the coronavirus disease 2019 (COVID-19) are still unknown. In this retrospective observational study, we include all consecutive COVID-19 patients admitted to our center. They were divided into two groups according to the presence of myocardial injury. Clinical variables, Charlson Comorbidity Index (CCI), C-reactive protein (CRP), CAC (COVID-19-associated coagulopathy), defined according to the ISTH score, treatment and in-hospital events were collected. Between March and April 2020, 331 COVID-19 patients were enrolled, 72 of them (21.8%) with myocardial injury. Patients with myocardial injury showed a higher CCI score (median (interquartile range), 5 (4–7) vs. 2 (1–4), p = 0.001), higher CRP values (18.3 (9.6–25.9) mg/dL vs. 12.0 (5.4–19.4) mg/dL, p ˂ 0.001) and CAC score (1 (0–2) vs. 0 (0–1), p = 0.001), and had lower use of any anticoagulant (57 patients (82.6%) vs. 229 patients (90.9%), p = 0.078), than those without. In the adjusted logistic regression, CRP, myocardial injury, CCI and CAC score were positive independent predictors of mortality, whereas anticoagulants resulted as a protective factor. Myocardial injury in COVID-19 patients is associated with inflammation and coagulopathy, resulting in a worse in-hospital prognosis. Treatment with anticoagulant agents may help to improve in-hospital outcomes. MDPI 2021-05-13 /pmc/articles/PMC8152726/ /pubmed/34068127 http://dx.doi.org/10.3390/jcm10102096 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Arévalos, Victor Ortega-Paz, Luis Rodríguez-Arias, Juan José Calvo, Margarita Castrillo, Leticia Salazar, Anthony Roque, Merce Dantas, Ana Paula Sabaté, Manel Brugaletta, Salvatore Myocardial Injury in COVID-19 Patients: Association with Inflammation, Coagulopathy and In-Hospital Prognosis |
title | Myocardial Injury in COVID-19 Patients: Association with Inflammation, Coagulopathy and In-Hospital Prognosis |
title_full | Myocardial Injury in COVID-19 Patients: Association with Inflammation, Coagulopathy and In-Hospital Prognosis |
title_fullStr | Myocardial Injury in COVID-19 Patients: Association with Inflammation, Coagulopathy and In-Hospital Prognosis |
title_full_unstemmed | Myocardial Injury in COVID-19 Patients: Association with Inflammation, Coagulopathy and In-Hospital Prognosis |
title_short | Myocardial Injury in COVID-19 Patients: Association with Inflammation, Coagulopathy and In-Hospital Prognosis |
title_sort | myocardial injury in covid-19 patients: association with inflammation, coagulopathy and in-hospital prognosis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8152726/ https://www.ncbi.nlm.nih.gov/pubmed/34068127 http://dx.doi.org/10.3390/jcm10102096 |
work_keys_str_mv | AT arevalosvictor myocardialinjuryincovid19patientsassociationwithinflammationcoagulopathyandinhospitalprognosis AT ortegapazluis myocardialinjuryincovid19patientsassociationwithinflammationcoagulopathyandinhospitalprognosis AT rodriguezariasjuanjose myocardialinjuryincovid19patientsassociationwithinflammationcoagulopathyandinhospitalprognosis AT calvomargarita myocardialinjuryincovid19patientsassociationwithinflammationcoagulopathyandinhospitalprognosis AT castrilloleticia myocardialinjuryincovid19patientsassociationwithinflammationcoagulopathyandinhospitalprognosis AT salazaranthony myocardialinjuryincovid19patientsassociationwithinflammationcoagulopathyandinhospitalprognosis AT roquemerce myocardialinjuryincovid19patientsassociationwithinflammationcoagulopathyandinhospitalprognosis AT dantasanapaula myocardialinjuryincovid19patientsassociationwithinflammationcoagulopathyandinhospitalprognosis AT sabatemanel myocardialinjuryincovid19patientsassociationwithinflammationcoagulopathyandinhospitalprognosis AT brugalettasalvatore myocardialinjuryincovid19patientsassociationwithinflammationcoagulopathyandinhospitalprognosis |