Cardiovascular Manifestations and Outcomes in Patients Admitted with Severe COVID-19: Middle Eastern Country Multicenter Data

Alkindi, Fahad; Alhashmi, Khamis; Nadar, Sunil; Alharthi, Salma; Alsaidi, Khalid; Alrashdi, Tasneem; Alasmi, Shabib; Khamis, Feryal; Algafri, Adil; Allawati, Sultan; Alfarsi, Muzna; Murthi, Sathiya; Albusaidi, Mujahid; Balkhair, Abdullah; Alhadi, Hafidh; Alrasadi, Khalid; Alabri, Maather; Alissai, Maryam; Alkindi, Shihab; Alsabti, Hilal

OBJECTIVES: Coronavirus disease-19 (COVID-19) is caused by severe acute respiratory distress syndrome-coronavirus-2 (SARS-CoV-2) -that can affect the cardiovascular system. The aim of our study was to assess the cardiovascular manifestations and its effect on the overall mortality among patients with severe COVID-19 who were admitted in the intensive care units (ICU). METHODS: This is a retrospective, multicenter cohort study that included all adult patients admitted to the ICU with laboratory-confirmed COVID-19 in three major hospitals in Oman between March 1, 2020, and August 10, 2020. RESULTS: A total of 541 patients (mean age of 50.57 ± 15.57 years; 401 [74.1%] male) were included in the study of which 452 (83.5%) were discharged and 89 (16.5%) died during hospitalization. Evidence of cardiac involvement was found in 185 (34.2%) patients, which included raised troponin (31.6%), arrhythmias (4.3%), myocardial infarctions (2.6%), or drop in ejection fraction (0.9%). High troponin of >100 ng/l was associated with higher mortality (odds ratio [OR] = 7.98; 95% confidence interval [CI]: 4.20–15.15); P < 0.001). Patients with any cardiovascular involvement also had a high risk of dying (OR = 8.8; 95% CI: 4.6–16.5; P < 0.001). CONCLUSION: Almost a third of patients in our study had evidence of cardiovascular involvement which was mainly myocardial injury. This was associated with increased mortality.