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Prognostic significance of cardiac injury in COVID-19 patients with and without coronary artery disease.

  • Barman, Hasan Ali1
  • Atici, Adem2
  • Sahin, Irfan3
  • Alici, Gokhan1
  • Aktas Tekin, Esra4
  • Baycan, Ömer Faruk2
  • Ozturk, Fatih5
  • Oflar, Ersan6
  • Tugrul, Sevil3
  • Yavuz, Mustafa Baran3
  • Celik, Fatma Betul2
  • Oktay, Aysu2
  • Vahaboglu, Haluk7
  • Adas, Mine8
  • Turgut, Namigar4
  • Okuyan, Ertugrul3
  • Yildirmak, Mustafa Taner9
  • Gungor, Baris10
  • 1 Department of Cardiology, Prof. Dr. Cemil Tascioglu City Hospital.
  • 2 Department of Cardiology, Istanbul Medeniyet University, Goztepe Training and Research Hospital.
  • 3 Department of Cardiology, Bagcilar Training and Research Hospital.
  • 4 Department of Anesthesiology and Intensive Care, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul.
  • 5 Department of Cardiology, Yuzunci Yil University, Faculty of Medicine, Van.
  • 6 Department of Cardiology, Dr. Sadi Konuk Training and Research Hospital.
  • 7 Department of Infectious Diseases, Istanbul Medeniyet University, Goztepe Training and Research Hospital.
  • 8 Departments of Internal Medicine.
  • 9 Infectious Diseases and Clinical Microbiology, Prof. Dr. Cemil Tascioglu City Hospital.
  • 10 Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey. , (Turkey)
Published Article
Coronary artery disease
Publication Date
Aug 01, 2021
DOI: 10.1097/MCA.0000000000000914
PMID: 32568741


COVID-19 is a disease with high mortality, and risk factors for worse clinical outcome have not been well-defined yet. The aim of this study is to delineate the prognostic importance of presence of concomitant cardiac injury on admission in patients with COVID-19. For this multi-center retrospective study, data of consecutive patients who were treated for COVID-19 between 20 March and 20 April 2020 were collected. Clinical characteristics, laboratory findings and outcomes data were obtained from electronic medical records. In-hospital clinical outcome was compared between patients with and without cardiac injury. A total of 607 hospitalized patients with COVID-19 were included in the study; the median age was 62.5 ± 14.3 years, and 334 (55%) were male. Cardiac injury was detected in 150 (24.7%) of patients included in the study. Mortality rate was higher in patients with cardiac injury (42% vs. 8%; P < 0.01). The frequency of patients who required ICU (72% vs. 19%), who developed acute kidney injury (14% vs. 1%) and acute respiratory distress syndrome (71%vs. 18%) were also higher in patients with cardiac injury. In multivariate analysis, age, coronary artery disease (CAD), elevated CRP levels, and presence of cardiac injury [odds ratio (OR) 10.58, 95% confidence interval (CI) 2.42-46.27; P < 0.001) were found to be independent predictors of mortality. In subgroup analysis, including patients free of history of CAD, presence of cardiac injury on admission also predicted mortality (OR 2.52, 95% CI 1.17-5.45; P = 0.018). Cardiac injury on admission is associated with worse clinical outcome and higher mortality risk in COVID-19 patients including patients free of previous CAD diagnosis. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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