Rohit Bhattacharjee, Amity University Kolkata
Cardiac troponin elevations in COVID 19 are common in myocardial injuries, also proposed as a prognostic factor. Important knowledge gaps remain in comprehending the clinical implications and epidemiology of myocardial injury. It is also not clear whether the incidence of myocardial injury in COVID-19 patients is higher than that observed in ARDS (Acute Respiratory Distress Syndrome). ARDS is the most common cause of hypoxemic respiratory failure manifesting into acute hypoxemia.
The goal was to determine the outcomes and objectives of myocardial injury in COVID-19 patients as compared to non-COVID ARDS. Troponin levels were assessed between the COVID-19 patients and the ones from a cohort study of myocardial injury in ARDS. Linear regression was performed to identify clinical factors with myocardial injuries in COVID-19. It was found that chronic kidney disease, lactate, fibrinogen, and ferritin was associated with myocardial injury. COVID-19 patients were older having high creatinine and low vital signs as compared to non-COVID ARDS. After certain adjustments, it was observed that COVID-19 patients had lower odds of myocardial injury as compared to non-COVID ARDS. Myocardial injury in severe COVID-19 is a function of baseline comorbidities, advanced age, and multisystem organ dysfunction like traditional ARDS and the adverse prognosis of myocardial injury in COVID-19 relates largely to multisystem organ involvement and critical illness.
Also read: COVID-19 infection in a pregnant woman with liver cytolysis
Source:-
- https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.050543
- Santoso A, Pranata R, Wibowo A, Al-Farabi MJ, Huang I and Antariksa B. Cardiac injury is associated with mortality and critically ill pneumonia in COVID-19: A meta-analysis. Am J Emerg Med. 2020. doi: 10.1016/j.ajem.2020.04.052.
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