| dc.description.abstract | Background: In this systematic review and meta-analysis, we aimed to explore the association between cardiac
injury and mortality, the need for intensive care unit (ICU) care, acute respiratory distress syndrome (ARDS),
and severe coronavirus disease 2019 (COVID-19) in patients with COVID-19 pneumonia.
Methods: We performed a comprehensive literature search from several databases. Definition of cardiac injury
follows that of the included studies, which includes highly sensitive cardiac troponin I (hs-cTnl) N99th percentile.The primary outcome was mortality, and the secondary outcomes were ARDS, the need for ICU care, and severe COVID-19. ARDS and severe COVID-19 were defined per the World Health Organization (WHO) interim
guidance of severe acute respiratory infection (SARI) of COVID-19.
Results: There were a total of 2389 patients from 13 studies. This meta-analysis showed that cardiac injury was
associated with higher mortality (RR 7.95 [5.12, 12.34], p b 0.001; I2
: 65%). Cardiac injury was associated with
higher need for ICU care (RR 7.94 [1.51, 41.78], p = 0.01; I2
: 79%), and severe COVID-19 (RR 13.81 [5.52,
34.52], p b 0.001; I2
: 0%). The cardiac injury was not significant for increased risk of ARDS (RR 2.57 [0.96, 6.85],
p = 0.06; I2
: 84%). The level of hs-cTnI was higher in patients with primary + secondary outcome (mean difference 10.38 pg/mL [4.44, 16.32], p = 0.002; I2
: 0%).
Conclusion: Cardiac injury is associated with mortality, need for ICU care, and severity of disease in patients with
COVID-19. | |
