Cardiology and Cardiovascular Research

Research Article | | Peer-Reviewed |

Mortality Predictors in Patients with Cardiovascular Involvement by COVID-19

Received: 11 January 2024    Accepted: 25 January 2024    Published: 20 February 2024
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Abstract

Introduction: SARS-CoV-2 is a new coronavirus responsible for one of the most evident diseases today, COVID-19, registering approximately 419,000 deaths until 2020. Some risk factors for infection and mortality must be assessed in clinical and research scenarios, such as the presence of cardiovascular diseases, with clinical and laboratory alterations. Objective: Our study aims to analyze the association between clinical and laboratory data and in-hospital mortality in patients with cardiovascular involvement by COVID-19 in Brazil. Method: This is a retrospective, observational, single-center cohort study. The sample consisted of patients admitted to a reference hospital from July 2020 to April 2021. We included patients over 18 years of age, hospitalized with COVID-19 infection, who developed heart involvement identified by clinical or laboratory findings. Patients who were pregnant or had negative serological tests for COVID-19 were excluded. Clinical variables such as gender, age, comorbidities, medications used during hospitalization, chest computed-tomography findings, need for intensive care unit, need for mechanical ventilation, and need for intravenous vasoactive drugs were analyzed. The laboratory variables analyzed were: troponin, NT-proBNP and D-dimer levels. The endpoint of the study was in-hospital death. Statistical analysis of the collected data was performed using Pearson's Chi-square test, Student's T test; p values < 0.05 were considered statistically significant. Results: 139 patients were included, and 30 (21.58%) patients died during hospitalization. The group that evolved to death, compared to the discharge group, was older (71 vs 65 years; p = 0.03), had more pleural effusion on chest computed-tomography (36% vs 17%; p = 0.023), had higher troponin levels (40% vs 20%; p = 0.02), more need for intensive care (83% vs 52%; p = 0.002), orotracheal intubation (83% vs 26%; p = 0.001), use of norepinephrine (76% vs 18%; p = 0.001), use of dobutamine (16% vs 4%; p = 0.023), and use of unfractioned heparin (46% vs 21%; p = 0.005). Conclusion: Advanced age was significantly associated with in-hospital death. In radiological patterns, despite the high incidence of ground-glass opacities, pleural effusion was the only finding associated with mortality. Increased troponin levels, but not NT-proBNP or D-dimer, was associated with in-hospital mortality. The need for norepinephrine and dobutamine, in addition to Intensive Care Unit admission and orotracheal Intubation, were also more frequent in the group that presented death during hospitalization, as wells as the use of unfractionated heparin rather than enoxaparin.

DOI 10.11648/j.ccr.20240801.14
Published in Cardiology and Cardiovascular Research (Volume 8, Issue 1, March 2024)
Page(s) 21-28
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

COVID-19, SARS-CoV-2, Troponin T, Heart Diseases, Myocardial Ischemia, Indicators of Morbidity and Mortality

References
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Cite This Article
  • APA Style

    Barbosa, R. R., Barros, L. C. D., Sylvestre, R. C., Paganini, L. N., Lima, P. D., et al. (2024). Mortality Predictors in Patients with Cardiovascular Involvement by COVID-19. Cardiology and Cardiovascular Research, 8(1), 21-28. https://doi.org/10.11648/j.ccr.20240801.14

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    ACS Style

    Barbosa, R. R.; Barros, L. C. D.; Sylvestre, R. C.; Paganini, L. N.; Lima, P. D., et al. Mortality Predictors in Patients with Cardiovascular Involvement by COVID-19. Cardiol. Cardiovasc. Res. 2024, 8(1), 21-28. doi: 10.11648/j.ccr.20240801.14

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    AMA Style

    Barbosa RR, Barros LCD, Sylvestre RC, Paganini LN, Lima PD, et al. Mortality Predictors in Patients with Cardiovascular Involvement by COVID-19. Cardiol Cardiovasc Res. 2024;8(1):21-28. doi: 10.11648/j.ccr.20240801.14

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  • @article{10.11648/j.ccr.20240801.14,
      author = {Roberto Ramos Barbosa and Lucas Crespo de Barros and Rodolfo Costa Sylvestre and Larissa Novaes Paganini and Pietro Dall’Orto Lima and Lucas Martins Frizzera Borges and Darlan Dadalt and Glícia Chierici Baptista and Layla Pasolini Lott and Valentin Trevizani Neto and Eduardo Gomes Vieira and Amanda Alencar de Araujo and Hemely Almeida do Nascimento and Lucas Bandeira Lima and Rodrigo Monico Cavedo and Lucas Vieira Pinto and Amanda Lessa Martins and Emanuella Esteves Machado and Renato Giestas Serpa and Osmar Araujo Calil and Luiz Fernando Machado Barbosa},
      title = {Mortality Predictors in Patients with Cardiovascular Involvement by COVID-19},
      journal = {Cardiology and Cardiovascular Research},
      volume = {8},
      number = {1},
      pages = {21-28},
      doi = {10.11648/j.ccr.20240801.14},
      url = {https://doi.org/10.11648/j.ccr.20240801.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20240801.14},
      abstract = {Introduction: SARS-CoV-2 is a new coronavirus responsible for one of the most evident diseases today, COVID-19, registering approximately 419,000 deaths until 2020. Some risk factors for infection and mortality must be assessed in clinical and research scenarios, such as the presence of cardiovascular diseases, with clinical and laboratory alterations. Objective: Our study aims to analyze the association between clinical and laboratory data and in-hospital mortality in patients with cardiovascular involvement by COVID-19 in Brazil. Method: This is a retrospective, observational, single-center cohort study. The sample consisted of patients admitted to a reference hospital from July 2020 to April 2021. We included patients over 18 years of age, hospitalized with COVID-19 infection, who developed heart involvement identified by clinical or laboratory findings. Patients who were pregnant or had negative serological tests for COVID-19 were excluded. Clinical variables such as gender, age, comorbidities, medications used during hospitalization, chest computed-tomography findings, need for intensive care unit, need for mechanical ventilation, and need for intravenous vasoactive drugs were analyzed. The laboratory variables analyzed were: troponin, NT-proBNP and D-dimer levels. The endpoint of the study was in-hospital death. Statistical analysis of the collected data was performed using Pearson's Chi-square test, Student's T test; p values < 0.05 were considered statistically significant. Results: 139 patients were included, and 30 (21.58%) patients died during hospitalization. The group that evolved to death, compared to the discharge group, was older (71 vs 65 years; p = 0.03), had more pleural effusion on chest computed-tomography (36% vs 17%; p = 0.023), had higher troponin levels (40% vs 20%; p = 0.02), more need for intensive care (83% vs 52%; p = 0.002), orotracheal intubation (83% vs 26%; p = 0.001), use of norepinephrine (76% vs 18%; p = 0.001), use of dobutamine (16% vs 4%; p = 0.023), and use of unfractioned heparin (46% vs 21%; p = 0.005). Conclusion: Advanced age was significantly associated with in-hospital death. In radiological patterns, despite the high incidence of ground-glass opacities, pleural effusion was the only finding associated with mortality. Increased troponin levels, but not NT-proBNP or D-dimer, was associated with in-hospital mortality. The need for norepinephrine and dobutamine, in addition to Intensive Care Unit admission and orotracheal Intubation, were also more frequent in the group that presented death during hospitalization, as wells as the use of unfractionated heparin rather than enoxaparin.
    },
     year = {2024}
    }
    

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  • TY  - JOUR
    T1  - Mortality Predictors in Patients with Cardiovascular Involvement by COVID-19
    AU  - Roberto Ramos Barbosa
    AU  - Lucas Crespo de Barros
    AU  - Rodolfo Costa Sylvestre
    AU  - Larissa Novaes Paganini
    AU  - Pietro Dall’Orto Lima
    AU  - Lucas Martins Frizzera Borges
    AU  - Darlan Dadalt
    AU  - Glícia Chierici Baptista
    AU  - Layla Pasolini Lott
    AU  - Valentin Trevizani Neto
    AU  - Eduardo Gomes Vieira
    AU  - Amanda Alencar de Araujo
    AU  - Hemely Almeida do Nascimento
    AU  - Lucas Bandeira Lima
    AU  - Rodrigo Monico Cavedo
    AU  - Lucas Vieira Pinto
    AU  - Amanda Lessa Martins
    AU  - Emanuella Esteves Machado
    AU  - Renato Giestas Serpa
    AU  - Osmar Araujo Calil
    AU  - Luiz Fernando Machado Barbosa
    Y1  - 2024/02/20
    PY  - 2024
    N1  - https://doi.org/10.11648/j.ccr.20240801.14
    DO  - 10.11648/j.ccr.20240801.14
    T2  - Cardiology and Cardiovascular Research
    JF  - Cardiology and Cardiovascular Research
    JO  - Cardiology and Cardiovascular Research
    SP  - 21
    EP  - 28
    PB  - Science Publishing Group
    SN  - 2578-8914
    UR  - https://doi.org/10.11648/j.ccr.20240801.14
    AB  - Introduction: SARS-CoV-2 is a new coronavirus responsible for one of the most evident diseases today, COVID-19, registering approximately 419,000 deaths until 2020. Some risk factors for infection and mortality must be assessed in clinical and research scenarios, such as the presence of cardiovascular diseases, with clinical and laboratory alterations. Objective: Our study aims to analyze the association between clinical and laboratory data and in-hospital mortality in patients with cardiovascular involvement by COVID-19 in Brazil. Method: This is a retrospective, observational, single-center cohort study. The sample consisted of patients admitted to a reference hospital from July 2020 to April 2021. We included patients over 18 years of age, hospitalized with COVID-19 infection, who developed heart involvement identified by clinical or laboratory findings. Patients who were pregnant or had negative serological tests for COVID-19 were excluded. Clinical variables such as gender, age, comorbidities, medications used during hospitalization, chest computed-tomography findings, need for intensive care unit, need for mechanical ventilation, and need for intravenous vasoactive drugs were analyzed. The laboratory variables analyzed were: troponin, NT-proBNP and D-dimer levels. The endpoint of the study was in-hospital death. Statistical analysis of the collected data was performed using Pearson's Chi-square test, Student's T test; p values < 0.05 were considered statistically significant. Results: 139 patients were included, and 30 (21.58%) patients died during hospitalization. The group that evolved to death, compared to the discharge group, was older (71 vs 65 years; p = 0.03), had more pleural effusion on chest computed-tomography (36% vs 17%; p = 0.023), had higher troponin levels (40% vs 20%; p = 0.02), more need for intensive care (83% vs 52%; p = 0.002), orotracheal intubation (83% vs 26%; p = 0.001), use of norepinephrine (76% vs 18%; p = 0.001), use of dobutamine (16% vs 4%; p = 0.023), and use of unfractioned heparin (46% vs 21%; p = 0.005). Conclusion: Advanced age was significantly associated with in-hospital death. In radiological patterns, despite the high incidence of ground-glass opacities, pleural effusion was the only finding associated with mortality. Increased troponin levels, but not NT-proBNP or D-dimer, was associated with in-hospital mortality. The need for norepinephrine and dobutamine, in addition to Intensive Care Unit admission and orotracheal Intubation, were also more frequent in the group that presented death during hospitalization, as wells as the use of unfractionated heparin rather than enoxaparin.
    
    VL  - 8
    IS  - 1
    ER  - 

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Author Information
  • Cardiology Department, Holy House of Mercy Hospital, Vitória-ES, Brazil; Holy House of Mercy Medical School (EMESCAM), Vitória-ES, Brazil

  • Cardiology Department, Holy House of Mercy Hospital, Vitória-ES, Brazil; Holy House of Mercy Medical School (EMESCAM), Vitória-ES, Brazil

  • Cardiology Department, Holy House of Mercy Hospital, Vitória-ES, Brazil

  • Cardiology Department, Holy House of Mercy Hospital, Vitória-ES, Brazil

  • Cardiology Department, Holy House of Mercy Hospital, Vitória-ES, Brazil

  • Cardiology Department, Holy House of Mercy Hospital, Vitória-ES, Brazil

  • Cardiology Department, Holy House of Mercy Hospital, Vitória-ES, Brazil

  • Cardiology Department, Holy House of Mercy Hospital, Vitória-ES, Brazil

  • Cardiology Department, Holy House of Mercy Hospital, Vitória-ES, Brazil

  • Cardiology Department, Holy House of Mercy Hospital, Vitória-ES, Brazil

  • Cardiology Department, Holy House of Mercy Hospital, Vitória-ES, Brazil

  • Holy House of Mercy Medical School (EMESCAM), Vitória-ES, Brazil

  • Holy House of Mercy Medical School (EMESCAM), Vitória-ES, Brazil

  • Holy House of Mercy Medical School (EMESCAM), Vitória-ES, Brazil

  • Holy House of Mercy Medical School (EMESCAM), Vitória-ES, Brazil

  • Holy House of Mercy Medical School (EMESCAM), Vitória-ES, Brazil

  • Holy House of Mercy Medical School (EMESCAM), Vitória-ES, Brazil

  • Holy House of Mercy Medical School (EMESCAM), Vitória-ES, Brazil

  • Cardiology Department, Holy House of Mercy Hospital, Vitória-ES, Brazil; Holy House of Mercy Medical School (EMESCAM), Vitória-ES, Brazil

  • Cardiology Department, Holy House of Mercy Hospital, Vitória-ES, Brazil; Holy House of Mercy Medical School (EMESCAM), Vitória-ES, Brazil

  • Cardiology Department, Holy House of Mercy Hospital, Vitória-ES, Brazil; Holy House of Mercy Medical School (EMESCAM), Vitória-ES, Brazil

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