scholarly journals Association of cardiac injury with hypertension in hospitalized patients with COVID-19 in China

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xiaofang Zeng ◽  
Anandharajan Rathinasabapathy ◽  
Dongliang Liu ◽  
Lihuang Zha ◽  
Xiangwei Liu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Demographic Data ◽  
Severe Disease ◽  
Cardiac Injury ◽  
High Sensitivity ◽  
Lactic Dehydrogenase ◽  
Moderate Increase ◽  
Laboratory Findings ◽  
Electrolyte Disorder ◽  
The Impact

AbstractOutbreak of global pandemic Coronavirus disease 2019 (COVID-19) has so far caused countless morbidity and mortality. However, a detailed report on the impact of COVID-19 on hypertension (HTN) and ensuing cardiac injury is unknown. Herein, we have evaluated the association between HTN and cardiac injury in 388 COVID-19 (47.5 ± 15.2 years) including 75 HTN and 313 normotension. Demographic data, cardiac injury markers, other laboratory findings, and comorbidity details were collected and analyzed. Compared to patients without HTN, hypertensive-COVID-19 patients were older, exhibited higher C-reactive protein (CRP), erythrocyte sedimentation rate, and comorbidities such as diabetes, coronary heart disease, cerebrovascular disease and chronic kidney disease. Further, these hypertensive-COVID-19 patients presented more severe disease with longer hospitalization time, and a concomitant higher rate of bilateral pneumonia, electrolyte disorder, hypoproteinemia and acute respiratory distress syndrome. In addition, cardiac injury markers such as creatine kinase (CK), myoglobin, lactic dehydrogenase (LDH), and N-terminal pro brain natriuretic peptide were significantly increased in these patients. Correlation analysis revealed that systolic blood pressure correlated significantly with the levels of CK, and LDH. Further, HTN was associated with increased LDH and CK-MB in COVID- 19 after adjusting essential variables. We also noticed that patients with elevated either high sensitivity-CRP or CRP demonstrated a significant high level of LDH along with a moderate increase in CK (p = 0.07) and CK-MB (p = 0.09). Our investigation suggested that hypertensive patients presented higher risk of cardiac injury and severe disease phenotype in COVID-19, effectively control blood pressure in HTN patients might improve the prognosis of COVID-19 patients.

Abstract 14661: High Sensitive Troponin Elevation Pattern in Covid-19 Era

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Alessandro Maino ◽  
Enrico Di Stasio ◽  
Maria Chiara Grimaldi ◽  
Luigi Cappannoli ◽  
Erica Rocco ◽  
...  
Keyword(s):  
Disease Severity ◽  
Demographic Data ◽  
Fatal Outcome ◽  
Treatment Strategies ◽  
High Sensitivity ◽  
Laboratory Findings ◽  
Reference Limit ◽  
Care Information ◽  
Upper Reference Limit ◽  
The Impact

Introduction: Coronavirus disease 2019 (COVID-19) is a pandemic disease that has caused a public health emergency due to its high rapid spread, to the high mortality rate, and the high percentage of patients requiring hospitalization and intensive care . Information regarding the impact of cardiovascular complication on fatal outcome is scarce. Purpose: To compare the levels of hs-Tn between patients affected by SARS-CoV-2 admitted to our hospital in the period February 20-April 9, 2020 versus the general population COVID free. Furthermore, we studied the dependence of hs-Tn levels in SARS-CoV-2 patients on disease severity and on other epidemiological, clinical and laboratory parameters. Methods: This retrospective single-center study analyzed all patients in whom hs-TnI was determined at the Policlinico A.Gemelli (Rome, Italy) from 20 February 2020 to 09 April 2020. One hundred-seventy of these patients received SARS-CoV-2 diagnosis. Demographic data, laboratory findings, comorbidities, and treatments were collected and analyzed in patients with COVID 19. Results: In our study, the population affected by SARS-CoV-2 (n=170) showed a significant association between disease severity and troponin levels (median [range] = 4.0 [<2.4-227.0], 13.5 [<2.4-545.0] and 34.0 [<2.4-45345.0], p<0.001, for mild, severe and critical state, respectively). Moreover, 27 subjects out of 170 (16%) showed high sensitivity troponin values higher than the 99 percentile upper reference limit stratified among previously defined severity classes as follows n=2 (2.4%), n=7 (15.9%) and n=18 (45.0%), respectively. Conclusions: The distribution of the troponin values greater than the cut-off in the SARS-CoV-2 population indicates a myocardial suffering independently related to COVID19 infection. This phenomenon may partially explain the high risk of adverse outcome in COVID-19 patients with underlying CVD. Therefore, it may be reasonable to triage patients with COVID-19 according to the presence of underlying CVD and evidence of myocardial injury for prioritized and personalized treatment strategies.

scholarly journals Hypertension as a sequela in patients of SARS-CoV-2 infection

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250815
Author(s):  
Ganxiao Chen ◽  
Xun Li ◽  
Zuojiong Gong ◽  
Hao Xia ◽  
Yao Wang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
White Blood Cells ◽  
Cardiac Injury ◽  
Clinical Signs ◽  
Area Under The Curve ◽  
Renin Angiotensin System ◽  
Lactic Dehydrogenase ◽  
Clinical Severity ◽  
Laboratory Findings ◽  
Good Ability

Background COVID-19 is a respiratory infectious disease caused by SARS-CoV-2, and cardiovascular damage is commonly observed in affected patients. We sought to investigate the effect of SARS-CoV-2 infection on cardiac injury and hypertension during the current coronavirus pandemic. Study design and methods The clinical data of 366 hospitalized COVID-19-confirmed patients were analyzed. The clinical signs and laboratory findings were extracted from electronic medical records. Two independent, experienced clinicians reviewed and analyzed the data. Results Cardiac injury was found in 11.19% (30/268) of enrolled patients. 93.33% (28/30) of cardiac injury cases were in the severe group. The laboratory findings indicated that white blood cells, neutrophils, procalcitonin, C-reactive protein, lactate, and lactic dehydrogenase were positively associated with cardiac injury marker. Compared with healthy controls, the 190 patients without prior hypertension have higher AngⅡ level, of which 16 (8.42%) patients had a rise in blood pressure to the diagnostic criteria of hypertension during hospitalization, with a significantly increased level of the cTnI, procalcitonin, angiotensin-II (AngⅡ) than those normal blood pressure ones. Multivariate analysis indicated that elevated age, cTnI, the history of hypertension, and diabetes were independent predictors for illness severity. The predictive model, based on the four parameters and gender, has a good ability to identify the clinical severity of COVID-19 in hospitalized patients (area under the curve: 0.932, sensitivity: 98.67%, specificity: 75.68%). Conclusion Hypertension, sometimes accompanied by elevated cTnI, may occur in COVID-19 patients and become a sequela. Enhancing Ang II signaling, driven by SARS-CoV-2 infection, might play an important role in the renin-angiotensin system, and consequently lead to the development of hypertension in COVID-19.

scholarly journals The Impact of Exercising During Haemodialysis on Blood Pressure, Markers of Cardiac Injury and Systemic Inflammation - Preliminary Results of a Pilot Study

2015 ◽  
Vol 40 (6) ◽  
pp. 593-604 ◽  
Author(s):  
Maurice Dungey ◽  
Nicolette C. Bishop ◽  
Hannah M.L. Young ◽  
James O. Burton ◽  
Alice C. Smith
Keyword(s):  
Blood Pressure ◽  
Pilot Study ◽  
Systemic Inflammation ◽  
Cardiac Injury ◽  
Preliminary Results ◽  
The Impact

scholarly journals Clinical Characteristics on Admission Predict In-Hospital Fatal Outcome in Patients Aged ≥75 Years with novel coronavirus disease (COVID-19): A Retrospective Cohort Study

2020 ◽  
Author(s):  
Zhihua Yu ◽  
Yuhe Ke ◽  
Jiang Xie ◽  
Hao Yu ◽  
Wei Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Temperature ◽  
Clinical Characteristics ◽  
Troponin I ◽  
Fatal Outcome ◽  
High Sensitivity ◽  
Lactic Dehydrogenase ◽  
Hospital Death ◽  
Laboratory Findings ◽  
Novel Coronavirus

Abstract Background：Novel coronavirus disease（COVID-19）has become a worldwide pandemic and precise fatality data by age group are needed urgently. This study to delineate the clinical characteristics and outcome of COVID-19 patients aged ≥75 years and identify the risk factors of in-hospital death.Methods：A total of 141 consecutive patients aged ≥75 years who were admitted to the hospital between 12th and 19th February 2020. In-hospital death, clinical characteristics and laboratory findings on admission were obtained from medical records. The final follow-up observation was 31st March 2020.Results：The median age was 81 years (84 female, 59.6%). Thirty-eight (27%) patients were classified as severe or critical cases. 18 (12.8%) patients had died in hospital and the remaining 123 were discharged. Patients who died were more likely to present with fever (38.9% vs. 7.3%); low percutaneous oxygen saturation(SpO2) (55.6% vs. 7.3%); reduced lymphocytes (72.2% vs. 35.8%) and platelets (27.8% vs. 4.1%); and increased D-dimer (94.4% vs. 42.3%), creatinine (50.0% vs. 22.0%), lactic dehydrogenase (LDH) (77.8% vs. 30.1%), high sensitivity troponin I (hs-TnI) (72.2% vs. 14.6%), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (72.2% vs. 6.5%; all P<0.05) than patients who recovered. Male sex (odds ratio [OR]=13.1, 95% confidence interval[CI] 1.1 to 160.1, P=0.044), body temperature >37.3°C (OR=80.5, 95% CI 4.6 to 1407.6, P=0.003), SpO2≤90% (OR=70.1, 95% CI 4.6 to 1060.4, P=0.002), and NT-proBNP>1800ng/L (OR=273.5, 95% CI 14.7 to 5104.8, P<0.0001) were independent risk factors of in-hospital death. Conclusions：In-hospital fatality among COVID-19 patients can be estimated by sex and on-admission measurements of body temperature, SpO2, and NT-proBNP.

scholarly journals Cardiac injury and mortality in patients with Coronavirus disease 2019 (COVID-19): insights from a mediation analysis

2020 ◽  
Author(s):  
Alberto Cipriani ◽  
Federico Capone ◽  
Filippo Donato ◽  
Leonardo Molinari ◽  
Davide Ceccato ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Mediation Analysis ◽  
Troponin I ◽  
Cardiac Injury ◽  
High Sensitivity ◽  
Lactic Dehydrogenase ◽  
Hospital Death ◽  
Relative Role ◽  
Chronic Coronary Artery Disease ◽  
Artery Disease

Abstract Backgrounds Patients at greatest risk of severe clinical conditions from coronavirus disease 2019 (COVID-19) and death are elderly and comorbid patients. Increased levels of cardiac troponins identify patients with poor outcome. The present study aimed to describe the clinical characteristics and outcomes of a cohort of Italian inpatients, admitted to a medical COVID-19 Unit, and to investigate the relative role of cardiac injury on in-hospital mortality. Methods and results We analyzed all consecutive patients with laboratory-confirmed COVID-19 referred to our dedicated medical Unit between February 26th and March 31st 2020. Patients’ clinical data including comorbidities, laboratory values, and outcomes were collected. Predictors of in-hospital mortality were investigated. A mediation analysis was performed to identify the potential mediators in the relationship between cardiac injury and mortality. A total of 109 COVID-19 inpatients (female 36%, median age 71 years) were included. During in-hospital stay, 20 patients (18%) died and, compared with survivors, these patients were older, had more comorbidities defined by Charlson comorbidity index ≥ 3(65% vs 24%, p = 0.001), and higher levels of high-sensitivity cardiac troponin I (Hs-cTnI), both at first evaluation and peak levels. A dose–response curve between Hs-cTnI and in-hospital mortality risk up to 200 ng/L was detected. Hs-cTnI, chronic kidney disease, and chronic coronary artery disease mediated most of the risk of in-hospital death, with Hs-cTnI mediating 25% of such effect. Smaller effects were observed for age, lactic dehydrogenase, and d-dimer. Conclusions In this cohort of elderly and comorbid COVID-19 patients, elevated Hs-cTnI levels were the most important and independent mediators of in-hospital mortality.

scholarly journals The Relationship between Gender, Severity of Disease, Treatment Type, and Employment Outcome in Patients with Inflammatory Bowel Disease in Israel

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Timna Naftali ◽  
Adi Eindor-Abarbanel ◽  
Nahum Ruhimovich ◽  
Ariella Bar-Gil Shitrit ◽  
Fabiana Sklerovsky-Benjaminov ◽  
...  
Keyword(s):  
Employment Status ◽  
Demographic Data ◽  
Severe Disease ◽  
Working Hours ◽  
Full Time ◽  
Biologic Treatment ◽  
Severity Of Disease ◽  
Treatment Type ◽  
Employment Rates ◽  
The Impact

Introduction. Since individuals with IBD typically experience symptoms during their prime years of employment, it raises the question about IBD impact on employment status. Most studies concentrated on absenteeism from work with varying results in different populations. However, absenteeism reflects only one dimension of the ability to work and does not expose the problem of inability to hold a full-time job. Aims. To evaluate the influence of IBD on unemployment and working hours in Israel. Secondary aims were to investigate the correlation between working hours and the type of medical treatment and the impact of severity of disease. Patients and Methods. Demographic data, employment status, number of weekly working hours, and disease parameters. The data was compared to that of the general Israeli population extracted from the website of the Central Bureau of Statistics. Results. 242 IBD patients were interviewed. Patients median age was 37.04(IQR 30.23-44.68) years and 88 (36.4%) were men and 154 (63.6%) women. Diagnosis of CD was established in 167 (69%) patients and UC in 65 (26.9%). There was no significant reduction in employment rates or working hours among the IBD patients comparing to the general population. Immunosuppressive or biologic treatment did not influence employment status. The unemployed patients had higher disease severity (median 7.33, IQR 5-10.66) compared to employed patients (median 6, IQR 3.66-7.66; p=0.003). Conclusions. Although IBD patients in Israel do not have higher unemployment, those with severe disease have lower proportion of employment.

scholarly journals Clinical Characteristics on Admission Predict In-Hospital Fatal Outcome in Patients Aged ≥75 Years with novel coronavirus disease (COVID-19) :A Retrospective Cohort Study

2020 ◽  
Author(s):  
Zhihua Yu ◽  
Yuhe Ke ◽  
Jiang Xie ◽  
Hao Yu ◽  
Wei Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Temperature ◽  
Clinical Characteristics ◽  
Troponin I ◽  
Fatal Outcome ◽  
High Sensitivity ◽  
Lactic Dehydrogenase ◽  
Hospital Death ◽  
Laboratory Findings ◽  
Novel Coronavirus

Abstract Background：Novel coronavirus disease（COVID-19）has become a worldwide pandemic and precise fatality data by age group are needed urgently. This study to delineate the clinical characteristics and outcome of COVID-19 patients aged ≥75 years and identify the risk factors of in-hospital death.Methods：A total of 141 consecutive patients aged ≥75 years who were admitted to the hospital between 12th and 19th February 2020. In-hospital death, clinical characteristics and laboratory findings on admission were obtained from medical records. The final follow-up observation was 31st March 2020.Results：The median age was 81 years (84 female, 59.6%). Thirty-eight (27%) patients were classified as severe or critical cases. 18 (12.8%) patients had died in hospital and the remaining 123 were discharged. Patients who died were more likely to present with fever (38.9% vs. 7.3%); low percutaneous oxygen saturation(SpO2) (55.6% vs. 7.3%); reduced lymphocytes (72.2% vs. 35.8%) and platelets (27.8% vs. 4.1%); and increased D-dimer (94.4% vs. 42.3%), creatinine (50.0% vs. 22.0%), lactic dehydrogenase (LDH) (77.8% vs. 30.1%), high sensitivity troponin I (hs-TnI) (72.2% vs. 14.6%), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (72.2% vs. 6.5%; all P<0.05) than patients who recovered. Male sex (odds ratio [OR]=13.1, 95% confidence interval[CI] 1.1 to 160.1, P=0.044), body temperature >37.3°C (OR=80.5, 95% CI 4.6 to 1407.6, P=0.003), SpO2≤90% (OR=70.1, 95% CI 4.6 to 1060.4, P=0.002), and NT-proBNP>1800ng/L (OR=273.5, 95% CI 14.7 to 5104.8, P<0.0001) were independent risk factors of in-hospital death. Conclusions：In-hospital fatality among COVID-19 patients can be estimated by sex and on-admission measurements of body temperature, SpO2, and NT-proBNP.

scholarly journals Elevated Plasma Fibrinogen Is Associated With Excessive Inflammation and Disease Severity in COVID-19 Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Jingrui Sui ◽  
Denis F. Noubouossie ◽  
Sheetal Gandotra ◽  
Liyun Cao
Keyword(s):  
Disease Severity ◽  
Troponin I ◽  
Medical Center ◽  
Severe Disease ◽  
Cardiac Injury ◽  
High Sensitivity ◽  
University Of Alabama ◽  
Optimal Cutoff ◽  
Icu Admission ◽  
The University

BackgroundThe coronavirus disease-19 (COVID-19) is characterized with intense inflammatory response, cardiac involvement, and coagulopathy. Fibrinogen, as a biomarker for inflammation, cardiovascular disease, and coagulation, has not been fully investigated yet. The aim of this study was to assess the clinical application of fibrinogen in COVID-19 patients.MethodsWe retrospectively analyzed the demographic and laboratory characteristics of 119 COVID-19 patients in the University of Alabama of Birmingham Medical Center. Correlations of fibrinogen on admission with intensive care unit (ICU) admission, disease severity, and laboratory parameters were analyzed.ResultsAmong the 119 COVID-19 patients, 77.3% (92/119) had severe disease, and 59.5% (71/119) patients were admitted to the ICU. Elevated fibrinogen was detected in 67.2% (80/119) of the patients. Fibrinogen levels were significantly associated with inflammatory markers and disease severity, but not with cardiac injury biomarker high sensitivity troponin I. Patients with severe disease had increased fibrinogen levels upon admission compared to patients with non-severe disease (P = 0.001). Fibrinogen level at 528.0 mg/dl was the optimal cutoff to predict disease severity, with a sensitivity and specificity of 66.7% and 70.3% (area undty -60er the curve [AUC] 0.72, P = 0.0006).ConclusionsFibrinogen is commonly elevated in COVID-19 patients, especially in those with severe disease. Elevated fibrinogen correlates with excessive inflammation, disease severity, and ICU admission in COVID-19 patients.

scholarly journals Impact of Congestive Heart Failure and Role of Cardiac Biomarkers in COVID-19 patients: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Tarun Dalia ◽  
Shubham Lahan ◽  
Sagar Ranka ◽  
Prakash Acharya ◽  
Archana Gautam ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Disease Severity ◽  
Troponin I ◽  
Severe Disease ◽  
Cardiac Injury ◽  
Cardiac Biomarkers ◽  
Pooled Data ◽  
Increased Risk ◽  
The Impact

Background: Coronavirus disease 2019 (COVID-19) has been reported to cause worse outcomes in patients with underlying cardiovascular disease, especially in patients with acute cardiac injury, which is determined by elevated levels of high-sensitivity troponin. There is a paucity of data on the impact of congestive heart failure (CHF) on outcomes in COVID-19 patients. Methods: We conducted a literature search of PubMed/Medline, EMBASE, and Google Scholar databases from 11/1/2019 till 06/07/2020, and identified all relevant studies reporting cardiovascular comorbidities, cardiac biomarkers, disease severity, and survival. Pooled data from the selected studies were used for metanalysis to identify the impact of risk factors and cardiac biomarker elevation on disease severity and/or mortality. Results: We collected pooled data on 5,967 COVID-19 patients from 20 individual studies. We found that both non-survivors and those with severe disease had an increased risk of acute cardiac injury and cardiac arrhythmias, our pooled relative risk (RR) was - 8.52 (95% CI 3.63-19.98) (p<0.001); and 3.61 (95% CI 2.03-6.43) (p=0.001), respectively. Mean difference in the levels of Troponin-I, CK-MB, and NT-proBNP was higher in deceased and severely infected patients. The RR of in-hospital mortality was 2.35 (95% CI 1.18-4.70) (p=0.022) and 1.52 (95% CI 1.12-2.05) (p=0.008) among patients who had pre-existing CHF and hypertension, respectively. Conclusion: Cardiac involvement in COVID-19 infection appears to significantly adversely impact patient prognosis and survival. Pre-existence of CHF and high cardiac biomarkers like NT-pro BNP and CK-MB levels in COVID-19 patients correlates with worse outcomes. Keywords: Acute cardiac injury; cardiac arrhythmia; mortality risk; cardiac biomarkers, COVID-19.

scholarly journals The Impact of Resting Heart Rate and Hypertension on the Prevalence of Stroke in Sudanese Adults: A Population- Based Cross Sectional Study

2021 ◽  
pp. 165-175
Author(s):  
D. A. Hassan ◽  
M. I. Elamin ◽  
M. Elamin ◽  
H. M. Beheiry ◽  
A. A. Abdalla ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Resting Heart Rate ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Increased Risk ◽  
The Impact

Aims: To investigate the effect of elevated resting heart rate (RHR), hypertension (HTN) and associated risk factors on the prevalence of stroke among Sudanese adults.  Study Design: This is a cross-sectional study based on a survey conducted by Sudanese society of hypertension during the May Month of Measurement (MMM), 2018 campaign. Methods: A total of 12281 respondents (mean age: 32.5±14.5 years, 49% men) were included. Structured questionnaires of demographic data, and self-reported medical history were filled by all respondents and analyzed.  Blood pressure and RHR were measured using an Omron BP monitor. Participants were divided into two main cohorts: normotensive (n=9497, 77.3%) and hypertensive (n=2784, 22.7%) participants. Each cohort was then segregated into three sub-cohorts using RHR tertiles (T1: <79 bpm; T2: RHR: 79 to 100 bpm; and T3:>100 bpm). Results: Multivariate logistic regression analyses were performed to assess the individual and combined effect of RHR and HTN on prevalence of stroke. Hypertensive patients were more likely to develop stroke compared to normotensive participants (OR= 2. 968, 95% CI 2.028-4.345). Within the hypertensive cohort, RHR T3 participants had a significantly increased risk of stroke compared to RHR T1-T2 combined (OR= 2.35, 95% CI1.043-5.323). Individuals of RHR T3 sub-cohort were more likely to be younger, leaner and displayed significantly higher level of both systolic & diastolic blood pressure compared to RHR T1 and T2 groups. Diabetes Mellitus and smoking increased the odds of stroke among both normotensives (OR (95% CI):5.6 (2.24- 14.09), 3.17 (1.71-6.08 respectively), and hypertensives (OR (95% CI): 4.40 (2.26-8.58), 2.03 (0.95-4.32) respectively). Female gender and older age also increases the odds of stroke among hypertensives (OR (95% CI): 1.85 (1.00- 3.45) and 2.00 (1.02- 4.17) respectively.   In conclusion, this study demonstrated that HTN was an independent risk factor of stroke. The effect of elevated RHR on stroke was only prominent when joined to high blood pressure. Prevalence of tachycardia was higher among the young participants which make them more prone to stroke if the condition is associated with HTN. Our results highlight the importance of addressing elevated RHR to reduce the risk of stroke particularly among hypertensive patients.  

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