Cardiac manifestations of COVID-19 in Shenzhen, China

• DOI: 10.1007/s15010-020-01473-w
• Publication Date: 2020-07-28T18:11:15Z
• Authors: Jia-Hui Zeng; Wei-Bo Wu; Jiu-Xin Qu; Yao Wang; Chang-Feng Dong; Yong-Fang Luo; Dan Zhou; Wen-Xia Feng; Cheng Feng
• Keywords: Microbiology (medical); Male; Original Paper; China; Critical Care; Heart Diseases; SARS-CoV-2; COVID-19; General Medicine; Comorbidity; Middle Aged; Prognosis; 3. Good health; Myocarditis; Infectious Diseases; Echocardiography; Heart Function Tests; Humans; Female; Radiography, Thoracic; Symptom Assessment; Aged

The coronavirus disease 2019 (COVID-19) outbreak has become a global public health concern; however, relatively few detailed reports of related cardiac injury are available. The aims of this study were to compare the clinical and echocardiographic characteristics of inpatients in the intensive-care unit (ICU) and non-ICU patients.We recruited 416 patients diagnosed with COVID-19 and divided them into two groups: ICU (n = 35) and non-ICU (n = 381). Medical histories, laboratory findings, and echocardiography data were compared.The levels of myocardial injury markers in ICU vs non-ICU patients were as follows: troponin I (0.029 ng/mL [0.007-0.063] vs 0.006 ng/mL [0.006-0.006]) and myoglobin (65.45 μg/L [39.77-130.57] vs 37.00 μg/L [26.40-53.54]). Echocardiographic findings included ventricular wall thickening (12 [39%] vs 1 [4%]), pulmonary hypertension (9 [29%] vs 0 [0%]), and reduced left-ventricular ejection fraction (5 [16%] vs 0 [0%]). Overall, 10% of the ICU patients presented with right heart enlargement, thickened right-ventricular wall, decreased right heart function, and pericardial effusion. Cardiac complications were more common in ICU patients, including acute cardiac injury (21 [60%] vs 13 [3%]) (including 2 cases of fulminant myocarditis), atrial or ventricular tachyarrhythmia (3 [9%] vs 3 [1%]), and acute heart failure (5 [14%] vs 0 [0%]).Myocardial injury marker elevation, ventricular wall thickening, pulmonary artery hypertension, and cardiac complications including acute myocardial injury, arrhythmia, and acute heart failure are more common in ICU patients with COVID-19. Cardiac injury in COVID-19 patients may be related more to the systemic response after infection rather than direct damage by coronavirus.