Long term outcomes: Link between COVID-19 hospitalization and myocardial injury

By Samar Mahmoud, MS
Published January 24, 2022

Key Takeaways

  • This longitudinal study found that patients who suffered myocardial injury during hospitalization for COVID-19 were at increased risk of all-cause mortality.

  • Although not statistically significant, these patients also had higher rates of hospital readmissions and were more likely to experience long-term COVID-19 symptoms.

  • To use assessment of myocardial injury as a clinical practice tool, larger scale prospective studies are still needed to elucidate the underlying mechanisms that govern how myocardial damage is linked to longer-term outcomes.

Myocardial injury during hospitalization for patients with SARS-CoV-2 infection has previously been associated with increased morbidity and mortality. However, studies assessing longer-term outcomes for these patients have been limited.

Why This Study Matters

This study bridges the gap by providing needed insight into the link between cardiovascular injury for COVID-19 patients during hospitalization and beyond, allowing physicians to use this knowledge as a predictive tool for which patients are more likely to have extended COVID-19 symptoms.

Study Design

This study included 483 patients who tested positive for COVID-19 and were hospitalized at a single center between March and May 2020. For each patient, Hs‐cTnT was measured and analyzed as a readout for myocardial injury, with levels classified as the following: undetectable (<6 ng/L), low‐level positive (6–14 ng/L), and myocardial injury (≥14 ng/L).

Investigators determined clinical outcomes, including cardiovascular, thrombotic, and infectious, during hospitalization as well as readmission using laboratory results, imaging, medications, and EHR documentation.

To evaluate longer-term outcomes, investigators evaluated patients through March 31, 2021 and determined whether patients had any ongoing symptoms since their COVID-19 infection, including chest pain, neurocognitive decline, and any decrease in functional status. 

Results and Conclusions

Of the 483 patients included in the study, 301 (62.3%) had cardiac injury (hs‐cTnT ≥14 ng/L), 123 (25.5%) had low-level positive hs‐cTnT, and 59 (12.2%) had an undetectable hs‐cTnT. Patients with cardiac injury were at increased risk of mortality, with rates of mortality for these patients being 28.6%, 32.2%, and 33.2% during hospitalization, at 6 months, and at 12 months, respectively.

This is in comparison to patients who had low-level positive hs‐cTnT and those with undetectable troponin levels, which had less than 5% and 0% mortality at 12 months, respectively. 

While patients with myocardial injury were more likely to be readmitted than patients without myocardial injury, this was not statistically significant after investigators adjusted for multiple variables.

Similarly, patients with higher levels of hs‐cTnT during the initial hospitalization were more likely to have ongoing COVID-19 symptoms at 6 months, with 56.4% of patients with long-term symptoms belonging to the myocardial injury group. 

Related Research

To learn more, consider these findings from similar research studies:

  • COVID-19 patients present with symptoms of fatigue and anxiety 6 months after onset of symptoms (Source)  

  • Fatal outcome of COVID-19 significantly linked to myocardial Injury (Source)

Original Source

Weber B, Siddiqi H, Zhou G, et al. Relationship between myocardial injury during index hospitalization for sars‐cov‐2 infection and longer‐term outcomes. Journal of the American Heart Association. 2022;11(1):e022010.

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