Acute myocardial injury is common in patients with COVID-19 and impairs their prognosis.
Identifieur interne : 000395 ( Main/Exploration ); précédent : 000394; suivant : 000396Acute myocardial injury is common in patients with COVID-19 and impairs their prognosis.
Auteurs : Jia-Fu Wei [République populaire de Chine] ; Fang-Yang Huang [République populaire de Chine] ; Tian-Yuan Xiong [République populaire de Chine] ; Qi Liu [République populaire de Chine] ; Hong Chen [République populaire de Chine] ; Hui Wang [République populaire de Chine] ; He Huang ; Yi-Chun Luo [République populaire de Chine] ; Xuan Zhou [République populaire de Chine] ; Zhi-Yue Liu [République populaire de Chine] ; Yong Peng [République populaire de Chine] ; Yuan-Ning Xu [République populaire de Chine] ; Bo Wang [République populaire de Chine] ; Ying-Ying Yang [République populaire de Chine] ; Zong-An Liang [République populaire de Chine] ; Xue-Zhong Lei [République populaire de Chine] ; Yang Ge [République populaire de Chine] ; Ming Yang [République populaire de Chine] ; Ling Zhang [République populaire de Chine] ; Ming-Quan Zeng [République populaire de Chine] ; He Yu [République populaire de Chine] ; Kai Liu [République populaire de Chine] ; Yu-Heng Jia [République populaire de Chine] ; Bernard D. Prendergast [Royaume-Uni] ; 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
Affiliations:
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Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></affiliation></author><author><name sortKey="Peng, Yong" sort="Peng, Yong" uniqKey="Peng Y" first="Yong" last="Peng">Yong Peng</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></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 wicri:level="1"><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></affiliation></author><author><name sortKey="Wang, Bo" sort="Wang, Bo" uniqKey="Wang B" first="Bo" last="Wang">Bo Wang</name><affiliation wicri:level="1"><nlm:affiliation>Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Intensive Care Unit, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></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 wicri:level="1"><nlm:affiliation>Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Nephrology, West China Hospital, Sichuan 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Chine</country><wicri:regionArea>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></affiliation></author><author><name sortKey="Ge, Yang" sort="Ge, Yang" uniqKey="Ge Y" first="Yang" last="Ge">Yang Ge</name><affiliation wicri:level="1"><nlm:affiliation>Department of Functional Examination Room, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Functional Examination Room, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province</wicri:regionArea><wicri:noRegion>Sichuan Province</wicri:noRegion></affiliation></author><author><name sortKey="Yang, Ming" sort="Yang, Ming" uniqKey="Yang M" first="Ming" last="Yang">Ming Yang</name><affiliation wicri:level="1"><nlm:affiliation>Department of Respiratory Medicine, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Respiratory Medicine, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province</wicri:regionArea><wicri:noRegion>Sichuan Province</wicri:noRegion></affiliation></author><author><name sortKey="Zhang, Ling" sort="Zhang, Ling" uniqKey="Zhang L" first="Ling" last="Zhang">Ling Zhang</name><affiliation wicri:level="1"><nlm:affiliation>Intensive Care Unit, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Intensive Care Unit, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province</wicri:regionArea><wicri:noRegion>Sichuan Province</wicri:noRegion></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 wicri:level="1"><nlm:affiliation>Intensive Care Unit, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Intensive Care Unit, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province</wicri:regionArea><wicri:noRegion>Sichuan Province</wicri:noRegion></affiliation></author><author><name sortKey="Yu, He" sort="Yu, He" uniqKey="Yu H" first="He" last="Yu">He Yu</name><affiliation wicri:level="1"><nlm:affiliation>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></affiliation></author><author><name sortKey="Liu, Kai" sort="Liu, Kai" uniqKey="Liu K" first="Kai" last="Liu">Kai Liu</name><affiliation wicri:level="1"><nlm:affiliation>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></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 wicri:level="1"><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></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 wicri:level="3"><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><country>Royaume-Uni</country><wicri:regionArea>Department of Cardiology, St Thomas' Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></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><wicri:noCountry code="subField">China hmaochen@vip.sina.com</wicri:noCountry></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><wicri:noCountry code="subField">China hmaochen@vip.sina.com</wicri:noCountry></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><idno type="wicri:Area/Main/Curation">000327</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000327</idno><idno type="wicri:Area/Main/Exploration">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 wicri:level="1"><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></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 wicri:level="1"><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></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 wicri:level="1"><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></affiliation></author><author><name sortKey="Liu, Qi" sort="Liu, Qi" uniqKey="Liu Q" first="Qi" last="Liu">Qi Liu</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></affiliation></author><author><name sortKey="Chen, Hong" sort="Chen, Hong" uniqKey="Chen H" first="Hong" last="Chen">Hong Chen</name><affiliation wicri:level="1"><nlm:affiliation>The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province</wicri:regionArea><wicri:noRegion>Sichuan Province</wicri:noRegion></affiliation></author><author><name sortKey="Wang, Hui" sort="Wang, Hui" uniqKey="Wang H" first="Hui" last="Wang">Hui Wang</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></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><wicri:noCountry code="subField">China hmaochen@vip.sina.com</wicri:noCountry></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 wicri:level="1"><nlm:affiliation>Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Radiology, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></affiliation></author><author><name sortKey="Zhou, Xuan" sort="Zhou, Xuan" uniqKey="Zhou X" first="Xuan" last="Zhou">Xuan Zhou</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Radiology, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></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 wicri:level="1"><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></affiliation></author><author><name sortKey="Peng, Yong" sort="Peng, Yong" uniqKey="Peng Y" first="Yong" last="Peng">Yong Peng</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></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 wicri:level="1"><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></affiliation></author><author><name sortKey="Wang, Bo" sort="Wang, Bo" uniqKey="Wang B" first="Bo" last="Wang">Bo Wang</name><affiliation wicri:level="1"><nlm:affiliation>Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Intensive Care Unit, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></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 wicri:level="1"><nlm:affiliation>Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Nephrology, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></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 wicri:level="1"><nlm:affiliation>Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></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 wicri:level="1"><nlm:affiliation>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></affiliation></author><author><name sortKey="Ge, Yang" sort="Ge, Yang" uniqKey="Ge Y" first="Yang" last="Ge">Yang Ge</name><affiliation wicri:level="1"><nlm:affiliation>Department of Functional Examination Room, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Functional Examination Room, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province</wicri:regionArea><wicri:noRegion>Sichuan Province</wicri:noRegion></affiliation></author><author><name sortKey="Yang, Ming" sort="Yang, Ming" uniqKey="Yang M" first="Ming" last="Yang">Ming Yang</name><affiliation wicri:level="1"><nlm:affiliation>Department of Respiratory Medicine, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Respiratory Medicine, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province</wicri:regionArea><wicri:noRegion>Sichuan Province</wicri:noRegion></affiliation></author><author><name sortKey="Zhang, Ling" sort="Zhang, Ling" uniqKey="Zhang L" first="Ling" last="Zhang">Ling Zhang</name><affiliation wicri:level="1"><nlm:affiliation>Intensive Care Unit, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Intensive Care Unit, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province</wicri:regionArea><wicri:noRegion>Sichuan Province</wicri:noRegion></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 wicri:level="1"><nlm:affiliation>Intensive Care Unit, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Intensive Care Unit, The Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province</wicri:regionArea><wicri:noRegion>Sichuan Province</wicri:noRegion></affiliation></author><author><name sortKey="Yu, He" sort="Yu, He" uniqKey="Yu H" first="He" last="Yu">He Yu</name><affiliation wicri:level="1"><nlm:affiliation>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></affiliation></author><author><name sortKey="Liu, Kai" sort="Liu, Kai" uniqKey="Liu K" first="Kai" last="Liu">Kai Liu</name><affiliation wicri:level="1"><nlm:affiliation>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></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 wicri:level="1"><nlm:affiliation>Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, West China Hospital, Sichuan University, Chengdu</wicri:regionArea><wicri:noRegion>Chengdu</wicri:noRegion></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 wicri:level="3"><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><country>Royaume-Uni</country><wicri:regionArea>Department of Cardiology, St Thomas' Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></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><wicri:noCountry code="subField">China hmaochen@vip.sina.com</wicri:noCountry></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><wicri:noCountry code="subField">China hmaochen@vip.sina.com</wicri:noCountry></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 PubStatus="medline"><Year>2020</Year><Month>5</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>5</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32354798</ArticleId><ArticleId IdType="pii">heartjnl-2020-317007</ArticleId><ArticleId IdType="doi">10.1136/heartjnl-2020-317007</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Royaume-Uni</li><li>République populaire de Chine</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><noCountry><name sortKey="Chen, Mao" sort="Chen, Mao" uniqKey="Chen M" first="Mao" last="Chen">Mao Chen</name><name sortKey="Huang, He" sort="Huang, He" uniqKey="Huang H" first="He" last="Huang">He Huang</name><name sortKey="Li, Wei Min" sort="Li, Wei Min" uniqKey="Li W" first="Wei-Min" last="Li">Wei-Min Li</name></noCountry><country name="République populaire de Chine"><noRegion><name sortKey="Wei, Jia Fu" sort="Wei, Jia Fu" uniqKey="Wei J" first="Jia-Fu" last="Wei">Jia-Fu Wei</name></noRegion><name sortKey="Chen, Hong" sort="Chen, Hong" uniqKey="Chen H" first="Hong" last="Chen">Hong Chen</name><name sortKey="Ge, Yang" sort="Ge, Yang" uniqKey="Ge Y" first="Yang" last="Ge">Yang Ge</name><name sortKey="Huang, Fang Yang" sort="Huang, Fang Yang" uniqKey="Huang F" first="Fang-Yang" last="Huang">Fang-Yang Huang</name><name sortKey="Jia, Yu Heng" sort="Jia, Yu Heng" uniqKey="Jia Y" first="Yu-Heng" last="Jia">Yu-Heng Jia</name><name sortKey="Lei, Xue Zhong" sort="Lei, Xue Zhong" uniqKey="Lei X" first="Xue-Zhong" last="Lei">Xue-Zhong Lei</name><name sortKey="Liang, Zong An" sort="Liang, Zong An" uniqKey="Liang Z" first="Zong-An" last="Liang">Zong-An Liang</name><name sortKey="Liu, Kai" sort="Liu, Kai" uniqKey="Liu K" first="Kai" last="Liu">Kai Liu</name><name sortKey="Liu, Qi" sort="Liu, Qi" uniqKey="Liu Q" first="Qi" last="Liu">Qi Liu</name><name sortKey="Liu, Zhi Yue" sort="Liu, Zhi Yue" uniqKey="Liu Z" first="Zhi-Yue" last="Liu">Zhi-Yue Liu</name><name sortKey="Luo, Yi Chun" sort="Luo, Yi Chun" uniqKey="Luo Y" first="Yi-Chun" last="Luo">Yi-Chun Luo</name><name sortKey="Peng, Yong" sort="Peng, Yong" uniqKey="Peng Y" first="Yong" last="Peng">Yong Peng</name><name sortKey="Wang, Bo" sort="Wang, Bo" uniqKey="Wang B" first="Bo" last="Wang">Bo Wang</name><name sortKey="Wang, Hui" sort="Wang, Hui" uniqKey="Wang H" first="Hui" last="Wang">Hui Wang</name><name sortKey="Xiong, Tian Yuan" sort="Xiong, Tian Yuan" uniqKey="Xiong T" first="Tian-Yuan" last="Xiong">Tian-Yuan Xiong</name><name sortKey="Xu, Yuan Ning" sort="Xu, Yuan Ning" uniqKey="Xu Y" first="Yuan-Ning" last="Xu">Yuan-Ning Xu</name><name sortKey="Yang, Ming" sort="Yang, Ming" uniqKey="Yang M" first="Ming" last="Yang">Ming Yang</name><name sortKey="Yang, Ying Ying" sort="Yang, Ying Ying" uniqKey="Yang Y" first="Ying-Ying" last="Yang">Ying-Ying Yang</name><name sortKey="Yu, He" sort="Yu, He" uniqKey="Yu H" first="He" last="Yu">He Yu</name><name sortKey="Zeng, Ming Quan" sort="Zeng, Ming Quan" uniqKey="Zeng M" first="Ming-Quan" last="Zeng">Ming-Quan Zeng</name><name sortKey="Zhang, Ling" sort="Zhang, Ling" uniqKey="Zhang L" first="Ling" last="Zhang">Ling Zhang</name><name sortKey="Zhou, Xuan" sort="Zhou, Xuan" uniqKey="Zhou X" first="Xuan" last="Zhou">Xuan Zhou</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Prendergast, Bernard D" sort="Prendergast, Bernard D" uniqKey="Prendergast B" first="Bernard D" last="Prendergast">Bernard D. 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