Retrospective Study of Risk Factors for Myocardial Damage in Patients With Critical Coronavirus Disease 2019 in Wuhan

Li, Lingzhi; Zhang, Shudi; He, Bing; Chen, Xiaobei; Zhao, Qingyan

BACKGROUND: The novel severe acute respiratory syndrome coronavirus 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 2 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. A total of 30 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 years old, 70.59% versus 37.50%; P=0.003) and patients with cardiovascular disease (41.18% versus 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 (hazard ratio [HR], 2.44; 95% CI, 1.01–5.40), CRP (C‐reactive protein) >100 mg/L (HR, 1.92; 95% CI, 0.94–3.92), lactate dehydrogenase >300 U/L (HR, 2.67; 95% CI, 1.03–6.90), and lactic acid >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 old), CRP >100 mg/L, lactate dehydrogenase >300 U/L, and lactic acid >3 mmol/L are high‐risk factors related to myocardial damage in critical patients with COVID‐19.