Acute myocardial injury is common in patients with COVID-19 and impairs their prognosis.
Identifieur interne : 000327 ( Main/Corpus ); précédent : 000326; suivant : 000328Acute myocardial injury is common in patients with COVID-19 and impairs their prognosis.
Auteurs : Jia-Fu Wei ; Fang-Yang Huang ; Tian-Yuan Xiong ; Qi Liu ; Hong Chen ; Hui Wang ; He Huang ; Yi-Chun Luo ; Xuan Zhou ; Zhi-Yue Liu ; Yong Peng ; Yuan-Ning Xu ; Bo Wang ; Ying-Ying Yang ; Zong-An Liang ; Xue-Zhong Lei ; Yang Ge ; Ming Yang ; Ling Zhang ; Ming-Quan Zeng ; He Yu ; Kai Liu ; Yu-Heng Jia ; Bernard D. Prendergast ; Wei-Min Li ; Mao ChenSource :
- Heart (British Cardiac Society) [ 1468-201X ] ; 2020.
Abstract
OBJECTIVE
We sought to explore the prevalence and immediate clinical implications of acute myocardial injury in a cohort of patients with COVID-19 in a region of China where medical resources are less stressed than in Wuhan (the epicentre of the pandemic).
METHODS
We prospectively assessed the medical records, laboratory results, chest CT images and use of medication in a cohort of patients presenting to two designated covid-19 treatment centres in Sichuan, China. Outcomes of interest included death, admission to an intensive care unit (ICU), need for mechanical ventilation, treatment with vasoactive agents and classification of disease severity. Acute myocardial injury was defined by a value of high-sensitivity troponin T (hs-TnT) greater than the normal upper limit.
RESULTS
A total of 101 cases were enrolled from January to 10 March 2020 (average age 49 years, IQR 34-62 years). Acute myocardial injury was present in 15.8% of patients, nearly half of whom had a hs-TnT value fivefold greater than the normal upper limit. Patients with acute myocardial injury were older, with a higher prevalence of pre-existing cardiovascular disease and more likely to require ICU admission (62.5% vs 24.7%, p=0.003), mechanical ventilation (43.5% vs 4.7%, p<0.001) and treatment with vasoactive agents (31.2% vs 0%, p<0.001). Log hs-TnT was associated with disease severity (OR 6.63, 95% CI 2.24 to 19.65), and all of the three deaths occurred in patients with acute myocardial injury.
CONCLUSION
Acute myocardial injury is common in patients with COVID-19 and is associated with adverse prognosis.
DOI: 10.1136/heartjnl-2020-317007
PubMed: 32354798
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Acute myocardial injury is common in patients with COVID-19 and impairs their prognosis.</title><author><name sortKey="Wei, Jia Fu" sort="Wei, Jia Fu" uniqKey="Wei J" first="Jia-Fu" last="Wei">Jia-Fu Wei</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Huang, Fang Yang" sort="Huang, Fang Yang" uniqKey="Huang F" first="Fang-Yang" last="Huang">Fang-Yang Huang</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Xiong, Tian Yuan" sort="Xiong, Tian Yuan" uniqKey="Xiong T" first="Tian-Yuan" last="Xiong">Tian-Yuan Xiong</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Liu, Qi" sort="Liu, Qi" uniqKey="Liu Q" first="Qi" last="Liu">Qi Liu</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Hong" sort="Chen, Hong" uniqKey="Chen H" first="Hong" last="Chen">Hong Chen</name><affiliation><nlm:affiliation>The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation></affiliation></author><author><name sortKey="Wang, Hui" sort="Wang, Hui" uniqKey="Wang H" first="Hui" last="Wang">Hui Wang</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Huang, He" sort="Huang, He" uniqKey="Huang H" first="He" last="Huang">He Huang</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China hmaochen@vip.sina.com weimi003@scu.edu.cn bernard.prendergast@gstt.nhs.uk huanghe@wchscu.cn.</nlm:affiliation></affiliation></author><author><name sortKey="Luo, Yi Chun" sort="Luo, Yi Chun" uniqKey="Luo Y" first="Yi-Chun" last="Luo">Yi-Chun Luo</name><affiliation><nlm:affiliation>Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Zhou, Xuan" sort="Zhou, Xuan" uniqKey="Zhou X" first="Xuan" last="Zhou">Xuan Zhou</name><affiliation><nlm:affiliation>Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Liu, Zhi Yue" sort="Liu, Zhi Yue" uniqKey="Liu Z" first="Zhi-Yue" last="Liu">Zhi-Yue Liu</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Peng, Yong" sort="Peng, Yong" uniqKey="Peng Y" first="Yong" last="Peng">Yong Peng</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Xu, Yuan Ning" sort="Xu, Yuan Ning" uniqKey="Xu Y" first="Yuan-Ning" last="Xu">Yuan-Ning Xu</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Wang, Bo" sort="Wang, Bo" uniqKey="Wang B" first="Bo" last="Wang">Bo Wang</name><affiliation><nlm:affiliation>Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Yang, Ying Ying" sort="Yang, Ying Ying" uniqKey="Yang Y" first="Ying-Ying" last="Yang">Ying-Ying Yang</name><affiliation><nlm:affiliation>Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Liang, Zong An" sort="Liang, Zong An" uniqKey="Liang Z" first="Zong-An" last="Liang">Zong-An Liang</name><affiliation><nlm:affiliation>Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lei, Xue Zhong" sort="Lei, Xue Zhong" uniqKey="Lei X" first="Xue-Zhong" last="Lei">Xue-Zhong Lei</name><affiliation><nlm:affiliation>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Ge, Yang" sort="Ge, Yang" uniqKey="Ge Y" first="Yang" last="Ge">Yang Ge</name><affiliation><nlm:affiliation>Department of Functional Examination Room, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation></affiliation></author><author><name sortKey="Yang, Ming" sort="Yang, Ming" uniqKey="Yang M" first="Ming" last="Yang">Ming Yang</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation></affiliation></author><author><name sortKey="Zhang, Ling" sort="Zhang, Ling" uniqKey="Zhang L" first="Ling" last="Zhang">Ling Zhang</name><affiliation><nlm:affiliation>Intensive Care Unit, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation></affiliation></author><author><name sortKey="Zeng, Ming Quan" sort="Zeng, Ming Quan" uniqKey="Zeng M" first="Ming-Quan" last="Zeng">Ming-Quan Zeng</name><affiliation><nlm:affiliation>Intensive Care Unit, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation></affiliation></author><author><name sortKey="Yu, He" sort="Yu, He" uniqKey="Yu H" first="He" last="Yu">He Yu</name><affiliation><nlm:affiliation>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Liu, Kai" sort="Liu, Kai" uniqKey="Liu K" first="Kai" last="Liu">Kai Liu</name><affiliation><nlm:affiliation>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Jia, Yu Heng" sort="Jia, Yu Heng" uniqKey="Jia Y" first="Yu-Heng" last="Jia">Yu-Heng Jia</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Prendergast, Bernard D" sort="Prendergast, Bernard D" uniqKey="Prendergast B" first="Bernard D" last="Prendergast">Bernard D. Prendergast</name><affiliation><nlm:affiliation>Department of Cardiology, St Thomas' Hospital, London, UK hmaochen@vip.sina.com weimi003@scu.edu.cn bernard.prendergast@gstt.nhs.uk huanghe@wchscu.cn.</nlm:affiliation></affiliation></author><author><name sortKey="Li, Wei Min" sort="Li, Wei Min" uniqKey="Li W" first="Wei-Min" last="Li">Wei-Min Li</name><affiliation><nlm:affiliation>Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China hmaochen@vip.sina.com weimi003@scu.edu.cn bernard.prendergast@gstt.nhs.uk huanghe@wchscu.cn.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Mao" sort="Chen, Mao" uniqKey="Chen M" first="Mao" last="Chen">Mao Chen</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China hmaochen@vip.sina.com weimi003@scu.edu.cn bernard.prendergast@gstt.nhs.uk huanghe@wchscu.cn.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32354798</idno><idno type="pmid">32354798</idno><idno type="doi">10.1136/heartjnl-2020-317007</idno><idno type="wicri:Area/Main/Corpus">000327</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000327</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Acute myocardial injury is common in patients with COVID-19 and impairs their prognosis.</title><author><name sortKey="Wei, Jia Fu" sort="Wei, Jia Fu" uniqKey="Wei J" first="Jia-Fu" last="Wei">Jia-Fu Wei</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Huang, Fang Yang" sort="Huang, Fang Yang" uniqKey="Huang F" first="Fang-Yang" last="Huang">Fang-Yang Huang</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Xiong, Tian Yuan" sort="Xiong, Tian Yuan" uniqKey="Xiong T" first="Tian-Yuan" last="Xiong">Tian-Yuan Xiong</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Liu, Qi" sort="Liu, Qi" uniqKey="Liu Q" first="Qi" last="Liu">Qi Liu</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Hong" sort="Chen, Hong" uniqKey="Chen H" first="Hong" last="Chen">Hong Chen</name><affiliation><nlm:affiliation>The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation></affiliation></author><author><name sortKey="Wang, Hui" sort="Wang, Hui" uniqKey="Wang H" first="Hui" last="Wang">Hui Wang</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Huang, He" sort="Huang, He" uniqKey="Huang H" first="He" last="Huang">He Huang</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China hmaochen@vip.sina.com weimi003@scu.edu.cn bernard.prendergast@gstt.nhs.uk huanghe@wchscu.cn.</nlm:affiliation></affiliation></author><author><name sortKey="Luo, Yi Chun" sort="Luo, Yi Chun" uniqKey="Luo Y" first="Yi-Chun" last="Luo">Yi-Chun Luo</name><affiliation><nlm:affiliation>Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Zhou, Xuan" sort="Zhou, Xuan" uniqKey="Zhou X" first="Xuan" last="Zhou">Xuan Zhou</name><affiliation><nlm:affiliation>Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Liu, Zhi Yue" sort="Liu, Zhi Yue" uniqKey="Liu Z" first="Zhi-Yue" last="Liu">Zhi-Yue Liu</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Peng, Yong" sort="Peng, Yong" uniqKey="Peng Y" first="Yong" last="Peng">Yong Peng</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Xu, Yuan Ning" sort="Xu, Yuan Ning" uniqKey="Xu Y" first="Yuan-Ning" last="Xu">Yuan-Ning Xu</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Wang, Bo" sort="Wang, Bo" uniqKey="Wang B" first="Bo" last="Wang">Bo Wang</name><affiliation><nlm:affiliation>Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Yang, Ying Ying" sort="Yang, Ying Ying" uniqKey="Yang Y" first="Ying-Ying" last="Yang">Ying-Ying Yang</name><affiliation><nlm:affiliation>Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Liang, Zong An" sort="Liang, Zong An" uniqKey="Liang Z" first="Zong-An" last="Liang">Zong-An Liang</name><affiliation><nlm:affiliation>Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lei, Xue Zhong" sort="Lei, Xue Zhong" uniqKey="Lei X" first="Xue-Zhong" last="Lei">Xue-Zhong Lei</name><affiliation><nlm:affiliation>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Ge, Yang" sort="Ge, Yang" uniqKey="Ge Y" first="Yang" last="Ge">Yang Ge</name><affiliation><nlm:affiliation>Department of Functional Examination Room, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation></affiliation></author><author><name sortKey="Yang, Ming" sort="Yang, Ming" uniqKey="Yang M" first="Ming" last="Yang">Ming Yang</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation></affiliation></author><author><name sortKey="Zhang, Ling" sort="Zhang, Ling" uniqKey="Zhang L" first="Ling" last="Zhang">Ling Zhang</name><affiliation><nlm:affiliation>Intensive Care Unit, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation></affiliation></author><author><name sortKey="Zeng, Ming Quan" sort="Zeng, Ming Quan" uniqKey="Zeng M" first="Ming-Quan" last="Zeng">Ming-Quan Zeng</name><affiliation><nlm:affiliation>Intensive Care Unit, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation></affiliation></author><author><name sortKey="Yu, He" sort="Yu, He" uniqKey="Yu H" first="He" last="Yu">He Yu</name><affiliation><nlm:affiliation>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Liu, Kai" sort="Liu, Kai" uniqKey="Liu K" first="Kai" last="Liu">Kai Liu</name><affiliation><nlm:affiliation>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Jia, Yu Heng" sort="Jia, Yu Heng" uniqKey="Jia Y" first="Yu-Heng" last="Jia">Yu-Heng Jia</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Prendergast, Bernard D" sort="Prendergast, Bernard D" uniqKey="Prendergast B" first="Bernard D" last="Prendergast">Bernard D. Prendergast</name><affiliation><nlm:affiliation>Department of Cardiology, St Thomas' Hospital, London, UK hmaochen@vip.sina.com weimi003@scu.edu.cn bernard.prendergast@gstt.nhs.uk huanghe@wchscu.cn.</nlm:affiliation></affiliation></author><author><name sortKey="Li, Wei Min" sort="Li, Wei Min" uniqKey="Li W" first="Wei-Min" last="Li">Wei-Min Li</name><affiliation><nlm:affiliation>Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China hmaochen@vip.sina.com weimi003@scu.edu.cn bernard.prendergast@gstt.nhs.uk huanghe@wchscu.cn.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Mao" sort="Chen, Mao" uniqKey="Chen M" first="Mao" last="Chen">Mao Chen</name><affiliation><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China hmaochen@vip.sina.com weimi003@scu.edu.cn bernard.prendergast@gstt.nhs.uk huanghe@wchscu.cn.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Heart (British Cardiac Society)</title><idno type="eISSN">1468-201X</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>We sought to explore the prevalence and immediate clinical implications of acute myocardial injury in a cohort of patients with COVID-19 in a region of China where medical resources are less stressed than in Wuhan (the epicentre of the pandemic).</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We prospectively assessed the medical records, laboratory results, chest CT images and use of medication in a cohort of patients presenting to two designated covid-19 treatment centres in Sichuan, China. Outcomes of interest included death, admission to an intensive care unit (ICU), need for mechanical ventilation, treatment with vasoactive agents and classification of disease severity. Acute myocardial injury was defined by a value of high-sensitivity troponin T (hs-TnT) greater than the normal upper limit.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>A total of 101 cases were enrolled from January to 10 March 2020 (average age 49 years, IQR 34-62 years). Acute myocardial injury was present in 15.8% of patients, nearly half of whom had a hs-TnT value fivefold greater than the normal upper limit. Patients with acute myocardial injury were older, with a higher prevalence of pre-existing cardiovascular disease and more likely to require ICU admission (62.5% vs 24.7%, p=0.003), mechanical ventilation (43.5% vs 4.7%, p<0.001) and treatment with vasoactive agents (31.2% vs 0%, p<0.001). Log hs-TnT was associated with disease severity (OR 6.63, 95% CI 2.24 to 19.65), and all of the three deaths occurred in patients with acute myocardial injury.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Acute myocardial injury is common in patients with COVID-19 and is associated with adverse prognosis.</p></div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">32354798</PMID><DateRevised><Year>2020</Year><Month>07</Month><Day>29</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1468-201X</ISSN><JournalIssue CitedMedium="Internet"><Volume>106</Volume><Issue>15</Issue><PubDate><Year>2020</Year><Month>Aug</Month></PubDate></JournalIssue><Title>Heart (British Cardiac Society)</Title><ISOAbbreviation>Heart</ISOAbbreviation></Journal><ArticleTitle>Acute myocardial injury is common in patients with COVID-19 and impairs their prognosis.</ArticleTitle><Pagination><MedlinePgn>1154-1159</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1136/heartjnl-2020-317007</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">We sought to explore the prevalence and immediate clinical implications of acute myocardial injury in a cohort of patients with COVID-19 in a region of China where medical resources are less stressed than in Wuhan (the epicentre of the pandemic).</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We prospectively assessed the medical records, laboratory results, chest CT images and use of medication in a cohort of patients presenting to two designated covid-19 treatment centres in Sichuan, China. Outcomes of interest included death, admission to an intensive care unit (ICU), need for mechanical ventilation, treatment with vasoactive agents and classification of disease severity. Acute myocardial injury was defined by a value of high-sensitivity troponin T (hs-TnT) greater than the normal upper limit.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 101 cases were enrolled from January to 10 March 2020 (average age 49 years, IQR 34-62 years). Acute myocardial injury was present in 15.8% of patients, nearly half of whom had a hs-TnT value fivefold greater than the normal upper limit. Patients with acute myocardial injury were older, with a higher prevalence of pre-existing cardiovascular disease and more likely to require ICU admission (62.5% vs 24.7%, p=0.003), mechanical ventilation (43.5% vs 4.7%, p<0.001) and treatment with vasoactive agents (31.2% vs 0%, p<0.001). Log hs-TnT was associated with disease severity (OR 6.63, 95% CI 2.24 to 19.65), and all of the three deaths occurred in patients with acute myocardial injury.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Acute myocardial injury is common in patients with COVID-19 and is associated with adverse prognosis.</AbstractText><CopyrightInformation>© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y" EqualContrib="Y"><LastName>Wei</LastName><ForeName>Jia-Fu</ForeName><Initials>JF</Initials><AffiliationInfo><Affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y" EqualContrib="Y"><LastName>Huang</LastName><ForeName>Fang-Yang</ForeName><Initials>FY</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-3049-2996</Identifier><AffiliationInfo><Affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y" EqualContrib="Y"><LastName>Xiong</LastName><ForeName>Tian-Yuan</ForeName><Initials>TY</Initials><AffiliationInfo><Affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y" EqualContrib="Y"><LastName>Liu</LastName><ForeName>Qi</ForeName><Initials>Q</Initials><AffiliationInfo><Affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y" EqualContrib="Y"><LastName>Chen</LastName><ForeName>Hong</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y" EqualContrib="Y"><LastName>Wang</LastName><ForeName>Hui</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Huang</LastName><ForeName>He</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China hmaochen@vip.sina.com weimi003@scu.edu.cn bernard.prendergast@gstt.nhs.uk huanghe@wchscu.cn.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Luo</LastName><ForeName>Yi-Chun</ForeName><Initials>YC</Initials><AffiliationInfo><Affiliation>Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhou</LastName><ForeName>Xuan</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liu</LastName><ForeName>Zhi-Yue</ForeName><Initials>ZY</Initials><AffiliationInfo><Affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Peng</LastName><ForeName>Yong</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Xu</LastName><ForeName>Yuan-Ning</ForeName><Initials>YN</Initials><AffiliationInfo><Affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Bo</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yang</LastName><ForeName>Ying-Ying</ForeName><Initials>YY</Initials><AffiliationInfo><Affiliation>Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liang</LastName><ForeName>Zong-An</ForeName><Initials>ZA</Initials><AffiliationInfo><Affiliation>Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lei</LastName><ForeName>Xue-Zhong</ForeName><Initials>XZ</Initials><AffiliationInfo><Affiliation>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ge</LastName><ForeName>Yang</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Functional Examination Room, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yang</LastName><ForeName>Ming</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Respiratory Medicine, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhang</LastName><ForeName>Ling</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Intensive Care Unit, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zeng</LastName><ForeName>Ming-Quan</ForeName><Initials>MQ</Initials><AffiliationInfo><Affiliation>Intensive Care Unit, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yu</LastName><ForeName>He</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liu</LastName><ForeName>Kai</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jia</LastName><ForeName>Yu-Heng</ForeName><Initials>YH</Initials><AffiliationInfo><Affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Prendergast</LastName><ForeName>Bernard D</ForeName><Initials>BD</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-6031-2124</Identifier><AffiliationInfo><Affiliation>Department of Cardiology, St Thomas' Hospital, London, UK hmaochen@vip.sina.com weimi003@scu.edu.cn bernard.prendergast@gstt.nhs.uk huanghe@wchscu.cn.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Wei-Min</ForeName><Initials>WM</Initials><AffiliationInfo><Affiliation>Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China hmaochen@vip.sina.com weimi003@scu.edu.cn bernard.prendergast@gstt.nhs.uk huanghe@wchscu.cn.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Mao</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China hmaochen@vip.sina.com weimi003@scu.edu.cn bernard.prendergast@gstt.nhs.uk huanghe@wchscu.cn.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>04</Month><Day>30</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Heart</MedlineTA><NlmUniqueID>9602087</NlmUniqueID><ISSNLinking>1355-6037</ISSNLinking></MedlineJournalInfo><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Heart. 2020 Aug;106(15):1122-1124</RefSource><PMID Version="1">32354799</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Nat Rev Cardiol. 2020 Aug;17(8):454</RefSource><PMID Version="1">32572194</PMID></CommentsCorrections></CommentsCorrectionsList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">myocardial disease</Keyword><Keyword MajorTopicYN="N">systemic inflammatory diseases</Keyword></KeywordList><CoiStatement>Competing interests: None declared.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>03</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>04</Month><Day>03</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>04</Month><Day>06</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>5</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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