Clinical observation of heart damage caused by coronavirus disease 2019

Objective: To investigate the heart damage of coronavirus disease 2019 (COVID-19) patients. Methods: A total of 785 cases of COVID-19 treated in the Affiliated Hospital of Jianghan University from December 25, 2019 to February 18, 2020 were retrospectively studied. Patients with myocardial injury were screened out and then were divided into survival and non-survival groups. The clinical manifestations, laboratory examinations, electrocardiograms, imaging examinations, and clinical outcomes of the two groups were observed, and the characteristics and prognosis of myocardial injury related to COVID-19 were analyzed. Results: (1) Of the 785 patients, 90 had elevated serum troponin and were identified as myocardial injury patients. (2) COVID-19 related myocardial injury correlated to age and history of underlying diseases. Most of them were elderly (mean age 71.64±16.42 years), accompanied by basic diseases such as hypertension, coronary heart disease, and diabetes.(3) The main clinical manifestations in COVID⁃19 with myocardial injury were palpitations (76.7%), chest tightness (60%), and chest pain (6.67%). There was no statistical difference between survival and non-survival groups ( P >0.05);Laboratory examinations showed that myocardial enzymes (CK, CK-MB, and LDH), myoglobin, hypersensitive troponin, and NT-ProBNP all increased in varying degrees, especially in non-survivors ( P <0.001). Hypersensitive troponin and NT-ProBNP were independent risk factors for death in COVID⁃19 patients with myocardial injury. (4) Of the 90 patients with myocardial injury, 84 showed abnormal electrocardiograms, including atrial/ventricular premature beats, ST-segment elevation, ST-segment shift, conduction block, and abnormal Q waves. There were significant difference in conduction block rate between survival and non⁃survival groups ( P <0.05). Conlusion: COVID⁃19 can cause myocardial damage. Troponin is an important indicator for myocardial damage. Troponin and NT-ProBNP are independent risk factors for predicting death of COVID⁃19. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.