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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...

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Autores principales: Arévalos, Victor, Ortega-Paz, Luis, Rodríguez-Arias, Juan José, Calvo, Margarita, Castrillo, Leticia, Salazar, Anthony, Roque, Merce, Dantas, Ana Paula, Sabaté, Manel, Brugaletta, Salvatore
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
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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.
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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
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