Myocardial injury and related mortality in hospitalized patients with COVID-19 during the Omicron pandemic: new perspectives and insights

Wu He; Ke Xu; Li Ni; Junfang Wu; Yuxuan Zhang; Kun Miao; Luyun Wang; Dao Wen Wang

doi:10.1016/j.virs.2023.10.005

December 2023

Citation: Wu He, Ke Xu, Li Ni, Junfang Wu, Yuxuan Zhang, Kun Miao, Luyun Wang, Dao Wen Wang. Myocardial injury and related mortality in hospitalized patients with COVID-19 during the Omicron pandemic: new perspectives and insights .VIROLOGICA SINICA, 2023, 38(6) : 940-950. http://dx.doi.org/10.1016/j.virs.2023.10.005

Myocardial injury and related mortality in hospitalized patients with COVID-19 during the Omicron pandemic: new perspectives and insights

Wu He ^a,b ,
Ke Xu ^a,b ,
Li Ni ^a,b ,
Junfang Wu ^a,b ,
Yuxuan Zhang ^a,b ,
Kun Miao ^a,b ,
Luyun Wang ^a,b ,
Dao Wen Wang ^{a,b
,,}

a. Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China;
b. Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, 430030, China

Corresponding author: Dao Wen Wang, dwwang@tjh.tjmu.edu.cn
Received Date: 04 July 2023
Accepted Date: 09 October 2023
Available online: 13 October 2023

Abstract

Myocardial injury is one of the most common comorbidity in SARS-CoV-2 infected patients, and has poor prognosis. However, the incidence of myocardial injury in patients with SARS-CoV-2 infection has not been sufficiently investigated during the Omicron wave. We conducted a retrospective study of 2690 patients with confirmed SARS-CoV-2 Omicron infection from Tongji Hospital. The results indicated that the myocardial injury accounted for 30.8% of the total patients with SARS-CoV-2 infection and was associated with higher in-hospital mortality than those without injury before and after propensity score matching (PSM) [adjusted hazard ratio (HR), 10.61; 95% confidence interval (CI), 7.76–14.51; P < 0.001; adjusted HR, 2.70; 95% CI, 1.86–3.93; P < 0.001; respectively]. Further, the levels of cytokines (IL-1β, IL-6, IL-10, and TNF-α) in patients with myocardial injury were higher than those without injury, and the higher levels of cytokines in the myocardial injury group were associated with increased mortality. Administration of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEI/ARB) could significantly reduce the mortality in patients with myocardial injury (adjusted HR, 0.52; 95% CI, 0.38–0.71; P < 0.001). Additionally, the level of angiotensin II increased in patients with SARS-CoV-2 infection was even higher in myocardial injury group compared to those without injury. Collectively, the study summarized the clinical characteristic and outcome of SARS-CoV-2 infected patients with myocardial injury during the Omicron wave in China, and validated the protective role of ACEI/ARB in improving the survival of those with myocardial injury.
- COVID-19
- , Omicron
- , Myocardial injury
- , In-hospital mortality
- , Cytokine storm

Electronic Supplementary Material

10.1016j.virs.2023.10.005-ESM.docx
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