Myocardial injury and its correlation to mortality in hospitalized COVID-19 patients: A retrospective cohort study

PURPOSE: This retrospective observational study was conducted to assess the clinical characteristics and outcomes of hospitalized COVID-19 patients with positive cardiac enzymes in the King Abdullah University Hospital (KAUH) in Irbid, Jordan. PATIENTS AND METHODS: A total of 676 patients admitted to KAUH for moderate-to-severe COVID-19 were included in the study. Clinical and mortality data were collected from patients’ electronic medical records. RESULTS: A significant association was found between myocardial injury and In-hospital mortality. Seven comorbidities were identified as risk factors for myocardial injury: Hypertension, diabetes mellitus (DM), previous cerebrovascular accident (CVA), ischemic heart disease (IHD), heart failure, chronic kidney disease (CKD), and cardiac arrhythmias. The need for intensive care unit (ICU) for invasive ventilation was also associated with myocardial injury. Acute kidney injury (AKI) during hospitalization had a significantly higher incidence of myocardial injury and mortality. Acute myocardial infarction (MI) and acute peripheral vascular disease (PVD) were also associated with higher mortality. CONCLUSION: Myocardial injury is an important predictor of mortality in patients with moderate-to-severe COVID-19 disease. Patients with a history of hypertension, diabetes mellitus, any vascular diseases, cardiac arrhythmias or heart failure are considered high-risk for adverse outcome. Additionally, COVID-19 patients with myocardial injury and acute kidney injury were recognized with the highest mortality rate.