Is it all in the heart? Myocardial injury as major predictor of mortality among hospitalized COVID‐19 patients (original) (raw)

2020, Journal of Medical Virology

Background: COVID-19, is a novel infection that has caused the most widespread pandemic in over 100 years. Given the relatively novelty of the disease, risk factors of mortality and adverse outcomes in hospitalized patients remain to be elucidated Objective: To define independent risk factors predictive fo mortality, need for ICU care, and mechanical ventilation among patients hospitalized with COVID-19 Design: Retrospective cohort study Setting: Large tertiary-care, academic university hospital Patients: Adults admitted with confirmed diagnosis of COVID-19 between March 1-April 15, 2020 Methods: Baseline clinical characteristics and admission laboratory variables were retrospectively collected. Patients were grouped based on mortality, need for ICU care, and mechanical ventilation. Prevalence of clinical co-morbidities and laboratory abnormalities were compared between groups using descriptive statistics. Univariate analysis was performed to identify predictors of mortality, ICU care and mechanical ventilation. Predictors significant at p≤0.10 were included in multivariate analysis. Results: 560 patients were included in the analysis. Age and myocardial injury were only independent predictors of mortality, in patients with/without baseline co-morbidities. BMI, elevated ferritin, elevated d-dimer, and elevated procalcitonin predicted need for This article is protected by copyright. All rights reserved. Accepted Article ICU care, and these along with vascular disease at baseline predicted need for mechanical ventilation. Limitations: All data were not available on each patient. Data on admission symptoms, vital signs, or imaging parameters were not collected. Conclusion: Age and myocardial injury are the strongest independent predictors of mortality among patients admitted with COVID-19. Inflammatory markers seem to have value in predicting need for ICU care and mechanical ventilation, but not death.