Cardiovascular manifestations and outcomes in patients admitted with severe COVID-19: Middle Eastern Country multicenter data
Fahad Alkindi1, Khamis Alhashmi2, Sunil Nadar1, Salma Alharthi3, Khalid Alsaidi4, Tasneem Alrashdi4, Shabib Alasmi4, Feryal Khamis4, Adil Algafri5, Sultan Allawati5, Muzna Alfarsi5, Sathiya Murthi3, Mujahid Albusaidi1, Abdullah Balkhair1, Hafidh Alhadi1, Khalid Alrasadi2, Maather Alabri2, Maryam Alissai2, Shihab Alkindi2, Hilal Alsabti2
1 Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
2 College of Medicine, Sultan Qaboos University, Muscat, Oman
3 Oman Medical Specialization Board, Muscat, Oman
4 Department of Cardiology, Royal Hospital, Muscat, Oman
5 Department of Medicine, Alnahda Hospital, Muscat, Oman
Cardiology Unit, Department of Medicine, Sultan Qaboos University Hospital, P. O. Box: 38/PC 123, Muscat
Cardiothoracic Surgery, Department of Surgery, Sultan Qaboos University Hospital, P. O. Box: 38/PC 123, Muscat
Source of Support: None, Conflict of Interest: None
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.