Types of myocardial injury and mid-term outcomes in patients with COVID-19

Abstract Aims To evaluate the acute and chronic patterns of myocardial injury among patients with coronavirus disease-2019 (COVID-19), their mid-term outcomes. Methods results Patients laboratory-confirmed COVID-19 who had a hospital encounter within Mount Sinai Health System (New York City) between 27 February 2020 15 October were evaluated for inclusion. Troponin levels assessed 72 h before 48 after diagnosis used to stratify study population by presence injury, as defined Fourth Universal Definition Myocardial Infarction. Among 4695 patients, those (n = 319, 6.8%) more comorbidities, including kidney disease heart failure, while 1168, 24.9%) was associated increased inflammatory markers. Both types strongly impaired survival at 6 months [chronic: hazard ratio (HR) 4.17, 95% confidence interval (CI) 3.44–5.06; acute: HR 4.72, CI 4.14–5.36], even excluding events occurring in first 30 days (chronic: 3.97, 2.15–7.33; 4.13, 2.75–6.21). The mortality risk not significantly different compared (HR 1.13, 0.94–1.36), except worse prognostic impact <65 years age (P-interaction 0.043) without coronary artery 0.041). Conclusion Chronic represent two distinctive cardiac involvement patients. While both are months, rates peak early phase infection but remain elevated beyond during convalescent phase.