Implications of myocardial injury in Mexican hospitalized patients with coronavirus disease 2019 (COVID-19).
Identifieur interne : 001085 ( Main/Exploration ); précédent : 001084; suivant : 001086Implications of myocardial injury in Mexican hospitalized patients with coronavirus disease 2019 (COVID-19).
Auteurs : Aquino Bruno Heberto [Mexique] ; Plata Corona Juan Carlos [Mexique] ; Castro Rubio José Antonio [Mexique] ; Pulido Pérez Patricia [Mexique] ; Torres Rasgado Enrique [Mexique] ; Morales Portano Julieta Danira [Mexique] ; G Mez Lvarez Enrique Benito [Mexique] ; Merino Rajme José Alfredo [Mexique]Source :
- International journal of cardiology. Heart & vasculature [ 2352-9067 ] ; 2020.
Abstract
Background
Respiratory illnesses is the most common manifestation of Coronavirus disease 2019 (COVID-19); however, myocardial injury has recently emerged as a frequent complication.
Methods
An observational, longitudinal, prospective, and multicenter study of hospitalized Mexican patients was made. We assessed the prevalence of myocardial injury and its relationship with complications and mortality.
Results
254 COVID-19 patients were included. Their average age was 53.8 years old, 167 (65.7%) were male and 87 (34.3%) female. According to troponin levels, two populations were generated, those with and without myocardial injury. There was no difference in gender or age between both groups. However, there was a greater proportion of obesity and hypertension in myocardial injury group. Multivariate logistic regression analysis revealed that obesity (OR 2.029, 95% CI 1.039-3.961; p = 0.038), arterial oxygen saturation <90% (OR 2.250, 95% CI 1.216-3.560; p = 0.025), and systolic blood pressure <90 mmHg (OR 2.636, 95% CI 1.530-4.343; p = 0.042), were directly related to higher levels of troponins. Multivariate cox proportional hazards analysis showed that primary endpoint (mortality) was determined by overweight/obesity (OR 1.290, 95% CI 0.115-0.730; p = 0.009), ferritin levels (OR 1.001, 95% CI 1.000-1.001; p < 0.001), myocardial injury (OR 3.764, 95% CI 1.307-10.838; p = 0.014), septic shock (OR 4.104, 95% CI 1.142-14.132; p = 0.024), acute respiratory distress syndrome (OR 3.001, 95% CI 1.008-10.165; p = 0.040), and treatment with Hydroxychloroquine/Azithromycin (OR 0.357, 95% IC 0.133-0.955; p = 0.040). Secondary endpoint (Mechanical ventilation risk) was associated to the same factors.
Conclusions
Myocardial injury represents an increased risk of complications and death in Mexican hospitalized patients with COVID-19.
DOI: 10.1016/j.ijcha.2020.100638
PubMed: 32953968
PubMed Central: PMC7486879
Affiliations:
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sortKey="Benito, G Mez Lvarez Enrique" sort="Benito, G Mez Lvarez Enrique" uniqKey="Benito G" first="G Mez Lvarez Enrique" last="Benito">G Mez Lvarez Enrique Benito</name><affiliation wicri:level="1"><nlm:affiliation>Centro Médico Nacional 20 de Noviembre, ISSSTE, Félix Cuevas 540, Col del Valle Sur, Benito Juárez, 03229 Ciudad de México, Mexico.</nlm:affiliation><country xml:lang="fr">Mexique</country><wicri:regionArea>Centro Médico Nacional 20 de Noviembre, ISSSTE, Félix Cuevas 540, Col del Valle Sur, Benito Juárez, 03229 Ciudad de México</wicri:regionArea><wicri:noRegion>03229 Ciudad de México</wicri:noRegion></affiliation></author><author><name sortKey="Alfredo, Merino Rajme Jose" sort="Alfredo, Merino Rajme Jose" uniqKey="Alfredo M" first="Merino Rajme José" last="Alfredo">Merino Rajme José Alfredo</name><affiliation wicri:level="1"><nlm:affiliation>Centro Médico Nacional 20 de Noviembre, ISSSTE, Félix Cuevas 540, Col del Valle Sur, Benito Juárez, 03229 Ciudad de México, 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injury in Mexican hospitalized patients with coronavirus disease 2019 (COVID-19).</title><author><name sortKey="Heberto, Aquino Bruno" sort="Heberto, Aquino Bruno" uniqKey="Heberto A" first="Aquino Bruno" last="Heberto">Aquino Bruno Heberto</name><affiliation wicri:level="1"><nlm:affiliation>Centro Médico Nacional 20 de Noviembre, ISSSTE, Félix Cuevas 540, Col del Valle Sur, Benito Juárez, 03229 Ciudad de México, Mexico.</nlm:affiliation><country xml:lang="fr">Mexique</country><wicri:regionArea>Centro Médico Nacional 20 de Noviembre, ISSSTE, Félix Cuevas 540, Col del Valle Sur, Benito Juárez, 03229 Ciudad de México</wicri:regionArea><wicri:noRegion>03229 Ciudad de México</wicri:noRegion></affiliation></author><author><name sortKey="Carlos, Plata Corona Juan" sort="Carlos, Plata Corona Juan" uniqKey="Carlos P" first="Plata Corona Juan" last="Carlos">Plata Corona Juan Carlos</name><affiliation wicri:level="1"><nlm:affiliation>Faculta de Medicina de la Benemérita, Universidad Autónoma de Puebla, Calle 13 Sur 2702, Colonia Los Volcanes, 72420 Puebla, Pue, Mexico.</nlm:affiliation><country xml:lang="fr">Mexique</country><wicri:regionArea>Faculta de Medicina de la Benemérita, Universidad Autónoma de Puebla, Calle 13 Sur 2702, Colonia Los Volcanes, 72420 Puebla, Pue</wicri:regionArea><wicri:noRegion>Pue</wicri:noRegion></affiliation></author><author><name sortKey="Antonio, Castro Rubio Jose" sort="Antonio, Castro Rubio Jose" uniqKey="Antonio C" first="Castro Rubio José" last="Antonio">Castro Rubio José Antonio</name><affiliation wicri:level="1"><nlm:affiliation>Hospital Regional de Alta Especialidad ISSSTE Puebla, Av. 14 Sur 4336, Zona Sin Asignación de Nom, Mexico.</nlm:affiliation><country xml:lang="fr">Mexique</country><wicri:regionArea>Hospital Regional de Alta Especialidad ISSSTE Puebla, Av. 14 Sur 4336, Zona Sin Asignación de Nom</wicri:regionArea><wicri:noRegion>Zona Sin Asignación de Nom</wicri:noRegion></affiliation></author><author><name sortKey="Patricia, Pulido Perez" sort="Patricia, Pulido Perez" uniqKey="Patricia P" first="Pulido Pérez" last="Patricia">Pulido Pérez Patricia</name><affiliation wicri:level="1"><nlm:affiliation>Faculta de Medicina de la Benemérita, Universidad Autónoma de Puebla, Calle 13 Sur 2702, Colonia Los Volcanes, 72420 Puebla, Pue, Mexico.</nlm:affiliation><country xml:lang="fr">Mexique</country><wicri:regionArea>Faculta de Medicina de la Benemérita, Universidad Autónoma de Puebla, Calle 13 Sur 2702, Colonia Los Volcanes, 72420 Puebla, Pue</wicri:regionArea><wicri:noRegion>Pue</wicri:noRegion></affiliation></author><author><name sortKey="Enrique, Torres Rasgado" sort="Enrique, Torres Rasgado" uniqKey="Enrique T" first="Torres Rasgado" last="Enrique">Torres Rasgado Enrique</name><affiliation wicri:level="1"><nlm:affiliation>Faculta de Medicina de la Benemérita, Universidad Autónoma de Puebla, Calle 13 Sur 2702, Colonia Los Volcanes, 72420 Puebla, Pue, Mexico.</nlm:affiliation><country xml:lang="fr">Mexique</country><wicri:regionArea>Faculta de Medicina de la Benemérita, Universidad Autónoma de Puebla, Calle 13 Sur 2702, Colonia Los Volcanes, 72420 Puebla, Pue</wicri:regionArea><wicri:noRegion>Pue</wicri:noRegion></affiliation></author><author><name sortKey="Danira, Morales Portano Julieta" sort="Danira, Morales Portano Julieta" uniqKey="Danira M" first="Morales Portano Julieta" last="Danira">Morales Portano Julieta Danira</name><affiliation wicri:level="1"><nlm:affiliation>Centro Médico Nacional 20 de Noviembre, ISSSTE, Félix Cuevas 540, Col del Valle Sur, Benito Juárez, 03229 Ciudad de México, Mexico.</nlm:affiliation><country xml:lang="fr">Mexique</country><wicri:regionArea>Centro Médico Nacional 20 de Noviembre, ISSSTE, Félix Cuevas 540, Col del Valle Sur, Benito Juárez, 03229 Ciudad de México</wicri:regionArea><wicri:noRegion>03229 Ciudad de México</wicri:noRegion></affiliation></author><author><name sortKey="Benito, G Mez Lvarez Enrique" sort="Benito, G Mez Lvarez Enrique" uniqKey="Benito G" first="G Mez Lvarez Enrique" last="Benito">G Mez Lvarez Enrique Benito</name><affiliation wicri:level="1"><nlm:affiliation>Centro Médico Nacional 20 de Noviembre, ISSSTE, Félix Cuevas 540, Col del Valle Sur, Benito Juárez, 03229 Ciudad de México, Mexico.</nlm:affiliation><country xml:lang="fr">Mexique</country><wicri:regionArea>Centro Médico Nacional 20 de Noviembre, ISSSTE, Félix Cuevas 540, Col del Valle Sur, Benito Juárez, 03229 Ciudad de México</wicri:regionArea><wicri:noRegion>03229 Ciudad de México</wicri:noRegion></affiliation></author><author><name sortKey="Alfredo, Merino Rajme Jose" sort="Alfredo, Merino Rajme Jose" uniqKey="Alfredo M" first="Merino Rajme José" last="Alfredo">Merino Rajme José Alfredo</name><affiliation wicri:level="1"><nlm:affiliation>Centro Médico Nacional 20 de Noviembre, ISSSTE, Félix Cuevas 540, Col del Valle Sur, Benito Juárez, 03229 Ciudad de México, Mexico.</nlm:affiliation><country xml:lang="fr">Mexique</country><wicri:regionArea>Centro Médico Nacional 20 de Noviembre, ISSSTE, Félix Cuevas 540, Col del Valle Sur, Benito Juárez, 03229 Ciudad de México</wicri:regionArea><wicri:noRegion>03229 Ciudad de México</wicri:noRegion></affiliation></author></analytic><series><title level="j">International journal of cardiology. Heart & vasculature</title><idno type="ISSN">2352-9067</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>Background</b></p><p>Respiratory illnesses is the most common manifestation of Coronavirus disease 2019 (COVID-19); however, myocardial injury has recently emerged as a frequent complication.</p></div><div type="abstract" xml:lang="en"><p><b>Methods</b></p><p>An observational, longitudinal, prospective, and multicenter study of hospitalized Mexican patients was made. We assessed the prevalence of myocardial injury and its relationship with complications and mortality.</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>254 COVID-19 patients were included. Their average age was 53.8 years old, 167 (65.7%) were male and 87 (34.3%) female. According to troponin levels, two populations were generated, those with and without myocardial injury. There was no difference in gender or age between both groups. However, there was a greater proportion of obesity and hypertension in myocardial injury group. Multivariate logistic regression analysis revealed that obesity (OR 2.029, 95% CI 1.039-3.961; p = 0.038), arterial oxygen saturation <90% (OR 2.250, 95% CI 1.216-3.560; p = 0.025), and systolic blood pressure <90 mmHg (OR 2.636, 95% CI 1.530-4.343; p = 0.042), were directly related to higher levels of troponins. Multivariate cox proportional hazards analysis showed that primary endpoint (mortality) was determined by overweight/obesity (OR 1.290, 95% CI 0.115-0.730; p = 0.009), ferritin levels (OR 1.001, 95% CI 1.000-1.001; p < 0.001), myocardial injury (OR 3.764, 95% CI 1.307-10.838; p = 0.014), septic shock (OR 4.104, 95% CI 1.142-14.132; p = 0.024), acute respiratory distress syndrome (OR 3.001, 95% CI 1.008-10.165; p = 0.040), and treatment with Hydroxychloroquine/Azithromycin (OR 0.357, 95% IC 0.133-0.955; p = 0.040). Secondary endpoint (Mechanical ventilation risk) was associated to the same factors.</p></div><div type="abstract" xml:lang="en"><p><b>Conclusions</b></p><p>Myocardial injury represents an increased risk of complications and death in Mexican hospitalized patients with COVID-19.</p></div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">32953968</PMID><DateRevised><Year>2020</Year><Month>10</Month><Day>20</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">2352-9067</ISSN><JournalIssue CitedMedium="Print"><Volume>30</Volume><PubDate><Year>2020</Year><Month>Oct</Month></PubDate></JournalIssue><Title>International journal of cardiology. Heart & vasculature</Title><ISOAbbreviation>Int J Cardiol Heart Vasc</ISOAbbreviation></Journal><ArticleTitle>Implications of myocardial injury in Mexican hospitalized patients with coronavirus disease 2019 (COVID-19).</ArticleTitle><Pagination><MedlinePgn>100638</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.ijcha.2020.100638</ELocationID><Abstract><AbstractText Label="Background" NlmCategory="UNASSIGNED">Respiratory illnesses is the most common manifestation of Coronavirus disease 2019 (COVID-19); however, myocardial injury has recently emerged as a frequent complication.</AbstractText><AbstractText Label="Methods" NlmCategory="UNASSIGNED">An observational, longitudinal, prospective, and multicenter study of hospitalized Mexican patients was made. We assessed the prevalence of myocardial injury and its relationship with complications and mortality.</AbstractText><AbstractText Label="Results" NlmCategory="UNASSIGNED">254 COVID-19 patients were included. Their average age was 53.8 years old, 167 (65.7%) were male and 87 (34.3%) female. According to troponin levels, two populations were generated, those with and without myocardial injury. There was no difference in gender or age between both groups. However, there was a greater proportion of obesity and hypertension in myocardial injury group. Multivariate logistic regression analysis revealed that obesity (OR 2.029, 95% CI 1.039-3.961; p = 0.038), arterial oxygen saturation <90% (OR 2.250, 95% CI 1.216-3.560; p = 0.025), and systolic blood pressure <90 mmHg (OR 2.636, 95% CI 1.530-4.343; p = 0.042), were directly related to higher levels of troponins. Multivariate cox proportional hazards analysis showed that primary endpoint (mortality) was determined by overweight/obesity (OR 1.290, 95% CI 0.115-0.730; p = 0.009), ferritin levels (OR 1.001, 95% CI 1.000-1.001; p < 0.001), myocardial injury (OR 3.764, 95% CI 1.307-10.838; p = 0.014), septic shock (OR 4.104, 95% CI 1.142-14.132; p = 0.024), acute respiratory distress syndrome (OR 3.001, 95% CI 1.008-10.165; p = 0.040), and treatment with Hydroxychloroquine/Azithromycin (OR 0.357, 95% IC 0.133-0.955; p = 0.040). Secondary endpoint (Mechanical ventilation risk) was associated to the same factors.</AbstractText><AbstractText Label="Conclusions" NlmCategory="UNASSIGNED">Myocardial injury represents an increased risk of complications and death in Mexican hospitalized patients with COVID-19.</AbstractText><CopyrightInformation>© 2020 The Author(s).</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Heberto</LastName><ForeName>Aquino Bruno</ForeName><Initials>AB</Initials><AffiliationInfo><Affiliation>Centro Médico Nacional 20 de Noviembre, ISSSTE, Félix Cuevas 540, Col del Valle Sur, Benito Juárez, 03229 Ciudad de México, Mexico.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Carlos</LastName><ForeName>Plata Corona Juan</ForeName><Initials>PCJ</Initials><AffiliationInfo><Affiliation>Faculta de Medicina de la Benemérita, Universidad Autónoma de Puebla, Calle 13 Sur 2702, Colonia Los Volcanes, 72420 Puebla, Pue, Mexico.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Antonio</LastName><ForeName>Castro Rubio José</ForeName><Initials>CRJ</Initials><AffiliationInfo><Affiliation>Hospital Regional de Alta Especialidad ISSSTE Puebla, Av. 14 Sur 4336, Zona Sin Asignación de Nom, Mexico.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Patricia</LastName><ForeName>Pulido Pérez</ForeName><Initials>PP</Initials><AffiliationInfo><Affiliation>Faculta de Medicina de la Benemérita, Universidad Autónoma de Puebla, Calle 13 Sur 2702, Colonia Los Volcanes, 72420 Puebla, Pue, Mexico.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Enrique</LastName><ForeName>Torres Rasgado</ForeName><Initials>TR</Initials><AffiliationInfo><Affiliation>Faculta de Medicina de la Benemérita, Universidad Autónoma de Puebla, Calle 13 Sur 2702, Colonia Los Volcanes, 72420 Puebla, Pue, Mexico.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Danira</LastName><ForeName>Morales Portano Julieta</ForeName><Initials>MPJ</Initials><AffiliationInfo><Affiliation>Centro Médico Nacional 20 de Noviembre, ISSSTE, Félix Cuevas 540, Col del Valle Sur, Benito Juárez, 03229 Ciudad de México, Mexico.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Benito</LastName><ForeName>Gómez Álvarez Enrique</ForeName><Initials>GÁE</Initials><AffiliationInfo><Affiliation>Centro Médico Nacional 20 de Noviembre, ISSSTE, Félix Cuevas 540, Col del Valle Sur, Benito Juárez, 03229 Ciudad de México, Mexico.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alfredo</LastName><ForeName>Merino Rajme José</ForeName><Initials>MRJ</Initials><AffiliationInfo><Affiliation>Centro Médico Nacional 20 de Noviembre, ISSSTE, Félix Cuevas 540, Col del Valle Sur, Benito Juárez, 03229 Ciudad de México, Mexico.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>09</Month><Day>12</Day></ArticleDate></Article><MedlineJournalInfo><Country>Ireland</Country><MedlineTA>Int J Cardiol Heart Vasc</MedlineTA><NlmUniqueID>101649525</NlmUniqueID><ISSNLinking>2352-9067</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Coronavirus</Keyword><Keyword MajorTopicYN="N">Myocardial injury</Keyword><Keyword MajorTopicYN="N">SARS-CoV-2</Keyword><Keyword MajorTopicYN="N">Troponins</Keyword></KeywordList><CoiStatement>The authors report no relationships that could be construed as a conflict of interest.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>06</Month><Day>16</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>08</Month><Day>07</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>09</Month><Day>07</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>9</Month><Day>22</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>21</Day><Hour>6</Hour><Minute>20</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32953968</ArticleId><ArticleId IdType="doi">10.1016/j.ijcha.2020.100638</ArticleId><ArticleId IdType="pii">S2352-9067(20)30336-5</ArticleId><ArticleId IdType="pmc">PMC7486879</ArticleId></ArticleIdList><pmc-dir>pmcsd</pmc-dir>
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IdType="pubmed">29524431</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Mexique</li></country></list><tree><country name="Mexique"><noRegion><name sortKey="Heberto, Aquino Bruno" sort="Heberto, Aquino Bruno" uniqKey="Heberto A" first="Aquino Bruno" last="Heberto">Aquino Bruno Heberto</name></noRegion><name sortKey="Alfredo, Merino Rajme Jose" sort="Alfredo, Merino Rajme Jose" uniqKey="Alfredo M" first="Merino Rajme José" last="Alfredo">Merino Rajme José Alfredo</name><name sortKey="Antonio, Castro Rubio Jose" sort="Antonio, Castro Rubio Jose" uniqKey="Antonio C" first="Castro Rubio José" last="Antonio">Castro Rubio José Antonio</name><name sortKey="Benito, G Mez Lvarez Enrique" sort="Benito, G Mez Lvarez Enrique" uniqKey="Benito G" first="G Mez Lvarez Enrique" last="Benito">G Mez Lvarez Enrique Benito</name><name sortKey="Carlos, Plata Corona Juan" sort="Carlos, Plata Corona Juan" uniqKey="Carlos P" first="Plata Corona Juan" last="Carlos">Plata Corona Juan Carlos</name><name sortKey="Danira, Morales Portano Julieta" sort="Danira, Morales Portano Julieta" uniqKey="Danira M" first="Morales Portano Julieta" last="Danira">Morales Portano Julieta Danira</name><name sortKey="Enrique, Torres Rasgado" sort="Enrique, Torres Rasgado" uniqKey="Enrique T" first="Torres Rasgado" last="Enrique">Torres Rasgado Enrique</name><name sortKey="Patricia, Pulido Perez" sort="Patricia, Pulido Perez" uniqKey="Patricia P" first="Pulido Pérez" last="Patricia">Pulido Pérez Patricia</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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