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On October 12, 2022, we reviewed a study published in Circulation: Cardiovascular Quality and Outcomes, that examined whether cardiovascular disease (CVD) is associated with in-hospital mortality and CV events in critically ill patients with COVID-19.
Researchers from Michigan Medicine analyzed hospital data from 5133 critically ill COVID-19 patients enrolled in the STOP COVID study. Records came from 68 US hospitals for patients admitted to intensive care units (ICU) between March 1 and July 1, 2020. Among those,1174 had preexisting coronary artery disease (CAD), congestive heart failure (CHF) or atrial fibrillation (AF). To help learn more about the contribution of CVD, a common condition among patients with severe COVID-19, to mortality in these patients, the Michigan Medicine researchers took advantage of data collected for the multicenter observational/registry, the Study of the Treatment and Outcomes in Critically Ill Patients With COVID-19 or STOP-COVID.
The investigators found that whether or not a patient had preexsting CVD, those who were assessed with myocardial injury when admitted to the ICU had higher odds of death (adjusted odds ratio, 1.93 [95% CI, 1.61–2.31]) and CV events (aOR, 1.82 [95% CI, 1.47–2.24]). Nearly half of ICU patients in the study presented to the ICU with myocardial injury, with higher troponin levels increasing the likelihood of death. In fact, mortality among patients with the highest troponin levels was nearly 3 times more likely than in those without evidence of the marker. Cardiac injury, the investigators suggest, may be a marker for severity of COVID-19 illness.
"While patients with severe COVID commonly had signs of cardiac injury, our findings reinforce COVID-19 as a pulmonary disease with multi-organ injury related to systemic inflammation. “The evidence of heart damage that we frequently see in patients with severe COVID-19 is more likely a reflection of the severity of the illness and the stress it imparts on all organs rather than the development of new complications or the exacerbation of preexisting cardiovascular disease," wrote investigators.