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Comparative frequency and prognostic impact of myocardial injury in hospitalized patients with COVID-19 and Influenza


ABSTRACT: Abstract

Aims

Myocardial injury (MINJ) in Coronavirus disease 2019 (COVID-19) identifies individuals at high mortality risk but its clinical relevance is less well established for Influenza and no comparative analyses evaluating frequency and clinical implications of MINJ among hospitalized patients with Influenza or COVID-19 are available.

Methods and Results

Hospitalized adults with laboratory confirmed Influenza A or B or COVID-19 underwent highly-sensitive cardiac T Troponin (hs-cTnT) measurement at admission in four regional hospitals in Canton Ticino, Switzerland. MINJ was defined as hs-cTnT >14 ng/L. Clinical, laboratory and outcome data were retrospectively collected. The primary outcome was mortality up to 28 days. Cox regression models were used to assess correlations between admission diagnosis, myocardial injury and mortality. Clinical correlates of MINJ in both viral diseases were also identified. MINJ occurred in 94 (65.5%) out of 145 patients hospitalized for Influenza and 216 (47.8%) out of 452 patients hospitalized for COVID-19. Advanced age and renal impairment were factors associated with myocardial injury in both diseases. At 28 days, 7 (4.8%) deaths occurred among Influenza and 76 deaths (16.8%) among COVID-19 patients with a hazard ratio (HR) of 3.69 (95%-CI 1.70-8.00). Adjusted Cox regression models showed admission diagnosis of COVID-19 [HR:6.41 (95%-CI 4.05-10.14)] and MINJ [HR:8.01 (95%-CI 4.64-13.82)] to be associated with mortality.

Conclusions

Myocardial injury is frequent among both viral diseases and increases the risk of death in both COVID-19 and Influenza. The absolute risk of death is considerably higher in patients admitted for COVID-19 as compared with Influenza. Graphical Abstract Graphical Abstract

SUBMITTER: Biasco L 

PROVIDER: S-EPMC8499788 | biostudies-literature |

REPOSITORIES: biostudies-literature

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