BACKGROUND: COVID-19 can cause myocardial injury in a significant proportion of patients admitted to the hospital and seems to be associated with worse prognosis . The aim of this review was to study how often and to what extent COVID-19 causes myocardial injury and whether this is an important contributor to outcome with implications for management .
METHODS: A literature search was performed in Medline and Embase . Myocardial injury was defined as elevated cardiac troponin (cTn) levels with at least one value> â¯99th percentile of the upper reference limit . The primary outcome measure was mortality, whereas secondary outcome measures were intensive care unit (ICU) admission and length of hospital stay .
RESULTS: Four studies and one review were included . The presence of myocardial injury varied between 9.6 and 46.3% . Myocardial injury was associated with a higher mortality rate (risk ratio (RR) 5.54 , 95% confidence interval (CI) 3.48-8.80) and more ICU admissions (RR 3.78 , 95% CI 2.07-6.89). The results regarding length of hospital stay were inconclusive .
CONCLUSION: Patients with myocardial injury might be classified as high-risk patients, with probably a higher mortality rate and a larger need for ICU admission . cTn levels can be used in risk stratification models and can indicate which patients potentially benefit from early medication administration . We recommend measuring cTn levels in all COVID-19 patients admitted to the hospital or who deteriorate during admission.