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Is it all in the heart? Myocardial injury as major predictor of mortality among hospitalized COVID‐19 patients
Author(s) -
Harmouch Farah,
Shah Kashyap,
Hippen John T.,
Kumar Ashish,
Goel Harsh
Publication year - 2021
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.26347
Subject(s) - medicine , procalcitonin , mechanical ventilation , retrospective cohort study , univariate analysis , intensive care unit , multivariate analysis , emergency medicine , sepsis
Coronavirus disease 2019 (COVID‐19) is an infection caused by the virus SARS‐CoV‐2, and has caused the most widespread global pandemic in over 100 years. Given the novelty of the disease, risk factors of mortality and adverse outcomes in hospitalized patients remain to be elucidated. We present the results of a retrospective cohort study including patients admitted to a large tertiary‐care, academic university hospital with COVID‐19. Patients were admitted with confirmed diagnosis of COVID‐19 between 1 March and 15 April 2020. 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 ≤ .10 were included in multivariate analysis. Five hundred and sixty patients were included in the analysis. Age and myocardial injury were only independent predictors of mortality, in patients with/without baseline co‐morbidities. Body mass index, elevated ferritin, elevated d‐dimer, and elevated procalcitonin predicted need for ICU care, and these along with vascular disease at baseline predicted need for mechanical ventilation. Hence, inflammatory markers (ferritin and d‐dimer) predicted severe disease, but not death.