¨ IMPLICATIONS OF MYOCARDIAL INJURY IN MEXICAN HOSPITALIZED PATIENTS WITH CORONAVIRUS DISEASE 2019 (COVID-19)

Bruno Heberto, Aquino; Corona Juan Carlos, Plata; Rubio José Antonio, Castro; Pérez Patricia, Pulido; Rasgado Enrique, Torres; Portano Julieta Danira, Morales; Álvarez Enrique Benito, Gómez; Rajme José Alfredo, Merino

Background Respiratory illnesses is the most common manifestation of Coronavirus disease 2019 (COVID-19); however, myocardial injury has recently emerged as a frequent complication. Methods An observational, longitudinal, prospective, and multicenter study of hospitalized Mexican patients was made. We assessed the prevalence of myocardial injury and its relationship with complications and mortality. Results 254 COVID-19 patients were included. Their average age was 53.8 years old, 167 (65.7%) were male and 87 (34.3%) female. According to troponin levels, two populations were generated, those with and without myocardial injury. There was no difference in gender or age between both groups. However, there was a greater proportion of obesity and hypertension in myocardial injury group. Multivariate logistic regression analysis revealed that obesity (OR 2.029, 95% CI 1.039-3.961; p=0.038), arterial oxygen saturation <90% (OR 2.250, 95% CI 1.216-3.560; p=0.025), and systolic blood pressure <90 mmHg (OR 2.636, 95% CI 1.530-4.343; p=0.042), were directly related to higher levels of troponins. Multivariate cox proportional hazards analysis showed that primary endpoint (mortality) was determined by overweight/obesity (OR 1.290, 95% CI 0.115-0.730; p=0.009), ferritin levels (OR 1.001, 95% CI 1.000-1.001; p<0.001), myocardial injury (OR 3.764, 95% CI 1.307-10.838; p=0.014), septic shock (OR 4.104, 95% CI 1.142-14.132; p=0.024), acute respiratory distress syndrome (OR 3.001, 95% CI 1.008-10.165; p=0.040), and treatment with Hydroxychloroquine/Azithromycin (OR 0.357, 95% IC 0.133-0.955; p=0.040) .Secondary endpoint (Mechanical ventilation risk) was associated to the same factors. Conclusions Myocardial injury represents an increased risk of complications and death in Mexican hospitalized patients with COVID-19.