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Journal of Peking University(Health Sciences) >

2021 , Vol. 53 >Issue 1: 159 - 166

DOI: https://doi.org/10.19723/j.issn.1671-167X.2021.01.024

Hypoxia and inflammation are risk factors for acute myocardial injury in patients with coronavirus disease 2019

  • Lin-cheng YANG ,
  • Rui-tao ZHANG ,
  • Li-jun GUO ,
  • Han XIAO ,
  • Ling-yun ZU ,
  • You-yi ZHANG ,
  • Qin CHENG ,
  • Zhi-ling ZHAO ,
  • Qing-gang GE ,
  • Wei GAO
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  • 1. Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital & NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides & Key Laboratory of Molecular Cardiovascular Science, Ministry of Education & Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing 100191, China
    2. Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
    3. Department of Intensive Care Medicine, Peking University Third Hospital, Beijing 100191, China

Received date: 2020-08-14

  Online published: 2021-02-07

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Abstract

Objective: To investigate the risk factors for acute myocardial injury in coronavirus disease 2019 (COVID-19) patients.Methods: This is a retrospective analysis of a COVID-19 cohort, in which 149 confirmed COVID-19 patients enrolled were divided into the group of myocardial injury (19 cases) and the group of non-myocardial injury (130 cases). Myocardial injury was defined according to Fourth universal definition of myocardial infarction released by European Society of Cardiology (ESC) in 2018, that cardiac troponin (cTn) was above 99th percentile of the reference level. Clinical information and results of laboratory tests of the eligible patients were collected. Factors associated with myocardial injury in COVID-19 patients were evaluated.Results: Compared with the group of non-injury, the patients in the group of injury were older and had a larger proportion of severe or critical cases (P<0.05), higher respiratory rate and lower percutaneous oxygen saturation (SpO2) without oxygen therapy on admission (P<0.05). All inflammatory indexes except for tumor necrosis factor α (TNF-α) showed significant elevation in the patients of the group of injury (P<0.05). Analyzed by Spearman correlation test, we showed that the levels of circulatory cTnI were in positive correlation with the levels of high-sensitivity C-reactive protein (hs-CRP), ferritin, receptor of interleukin-2 (IL-2R), interleukin-6 (IL-6) and interleukin-8 (IL-8) (ρ>0, P<0.05). Lower SpO2 without oxygen therapy on admission (OR: 0.860, 95%CI: 0.779-0.949, P=0.003) and higher plasma IL-6 levels (OR: 1.068, 95%CI: 1.019-1.120, P=0.006) were independent risk factors for acute myocardial injury in the patients with COVID-19 by multivariate Logistic regression analyses.Conclusion: Hypoxic state and inflammation may play a key role in the pathogenesis of acute myocardial injury in COVID-19 patients.

Key words： Betacoronavirus; Acute myocardial injury; Interleukin-6; Inflammation

Cite this article

Lin-cheng YANG , Rui-tao ZHANG , Li-jun GUO , Han XIAO , Ling-yun ZU , You-yi ZHANG , Qin CHENG , Zhi-ling ZHAO , Qing-gang GE , Wei GAO . Hypoxia and inflammation are risk factors for acute myocardial injury in patients with coronavirus disease 2019[J]. Journal of Peking University(Health Sciences), 2021 , 53(1) : 159 -166 . DOI: 10.19723/j.issn.1671-167X.2021.01.024

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