Non-Ischemic, Non-Hypoxic Myocardial Injury, and Long-Term Mortality in Patients with Coronavirus Disease 2019: A Retrospective Cohort Study

Objective:Cardiac damage is commonly reported in patients with coronavirus disease 2019(COVID-19)but its prevalence and impact on the long-term survival of patients remain uncertain.This study aimed to explore the prevalence of myocardial injury and assess its prognostic value in patients with COVID-19.Methods:A single-center,retrospective cohort study was performed at the Affiliated Hospital of Jianghan University.Data from 766 patients with confirmed COVID-19 who were hospitalized from December 27,2019 to April 25,2020 were collected.Demographic,clinical,laboratory,electrocardiogram,treatment data and all-cause mortality during follow-up were collected and analyzed.Results:Of the 766 patients with moderate to critically ill COVID-19,86(11.2%)died after a mean follow-up of 72.8 days.Myocardial injury occurred in 94(12.3%)patients.The mortality rate was 64.9%(61/94)and 3.7%(25/672)in patients with and without myocardial injury,respectively.Cox regression showed that myocardial injury was an independent risk factor for mortality(hazard ratio:8.76,95%confidence interval:4.76–16.11,P<0.001).Of the 90 patients with myocardial injury with electrocardiogram results,sinus tachycardia was present in 29,bundle branch block in 26,low voltage in 10,and abnormal T-wave in 53.Conclusions:COVID-19 not only involves pneumonia but also cardiac damage.Myocardial injury is a common complication and an independent risk factor for mortality in COVID-19 patients.