Li L, et al. J Am Heart Assoc 2020.
Background The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) threatens human health and the mortality rate is higher in patients who develop myocardial damage. However, the possible risk factors for myocardial damage in patients with coronavirus disease 2019 (COVID-19) are not fully known. Methods and Results Critical type patients were selected randomly from 204 confirmed COVID-19 cases occurring in Renmin Hospital of Wuhan University, from February 1, 2020 to February 24, 2020. Univariate analyses were used to compare the two groups: the myocardial damage group and the non-myocardial damage group. A total of 82 critical patients with COVID-19 were recruited: 34 with myocardial damage and 48 without myocardial damage. Thirty patients died in the myocardial damage group, and 20 died in the non-myocardial damage group. In univariate analysis, the proportion of elderly patients (>70 y: 70.59% vs 37.50%; P=0.003) and patients with cardiovascular disease (41.18% vs 12.50%; P=0.003) was higher among myocardial damage patients than among non-myocardial damage patients. Multivariate analysis showed that age>70 years old (HR 2.44, 95% CI 1.01-5.40), C-reactive protein greater than 100 mg/L (HR 1.92, 95% CI 0.94-3.92), lactate dehydrogenase greater than 300 U/L (HR 2.67, 95% CI 1.03-6.90), and lactic acid greater than 3 mmol/L (HR 3.25, 95% CI 1.57-6.75) were independent risk factors for myocardial damage in patients with COVID-19. Conclusions Old age (>70 years), C-reactive protein greater than 100 mg/L, lactate dehydrogenase greater than 300 U/L and lactic acid greater than 3 mmol/L are high-risk factors related to myocardial damage in critical patients with COVID-19.