Clinical and radiographic features of cardiac injury in patients with 2019 novel coronavirus pneumonia

  1. Hui Hui
  2. Yingqian Zhang
  3. Xin Yang
  4. Xi Wang
  5. Bingxi He
  6. Li Li
  7. Hongjun Li
  8. Jie Tian
  9. Yundai Chen

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Abstract

Objective

To investigate the correlation between clinical characteristics and cardiac injury of COVID-2019 pneumonia.

Methods

In this retrospective, single-center study, 41 consecutive corona virus disease 2019 (COVID-2019) patients (including 2 deaths) of COVID-2019 in Beijing Youan Hospital, China Jan 21 to Feb 03, 2020, were involved in this study. The high risk factors of cardiac injury in different COVID-2019 patients were analyzed. Computed tomographic (CT) imaging of epicardial adipose tissue (EAT) has been used to demonstrate the cardiac inflammation of COVID-2019.

Results

Of the 41 COVID-2019 patients, 2 (4.88%), 32 (78.05%), 4 (9.75%) and 3 (7.32%) patients were clinically diagnosed as light, mild, severe and critical cases, according to the 6 th guidance issued by the National Health Commission of China. 10 (24.4%) patients had underlying complications, such as hypertension, CAD, type 2 diabetes mellites and tumor. The peak value of TnI in critical patients is 40-fold more than normal value. 2 patients in the critical group had the onset of atrial fibrillation, and the peak heart rates reached up to 160 bpm. CT scan showed low EAT density in severe and critical patients.

Conclusion

Our results indicated that cardiac injury of COVID-2019 was rare in light and mild patients, while common in severe and critical patients. Therefore, the monitoring of the heart functions of COVID-2019 patients and applying potential interventions for those with abnormal cardiac injury related characteristics, is vital to prevent the fatality.

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    SciScore for 10.1101/2020.02.24.20027052: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: This study is in compliance with the Institutional Review Board of Beijing Youan Hospital, China.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analyses were conducted using SPSS software (version 19; SPSS Inc, Chicago, IL).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study has several limitations. First, only 41 confirmed COVID-19 patients from single center were included. It would be better to include as many patients as possible, even from multicenter, to get a more comprehensive understanding of cardiac injury of COVID-19. Second, more detailed heart function-related data, particularly including ECG or echocardiography, was unavailable at this time. Nonetheless, the data presented in this study allow an early assessment of the clinical characteristics of cardiac injury in COVID-19 patients. Finally, chest CT data of the patients in health was unobtainable to determinate the changes of heart functions with and without COVID-19 infection. In future study, the follow-up chest CT scan during hospitalization could be collected to quantify the change of EAT density in CT scans. In conclusion, this retrospective, single-center study of 41 confirmed COVID-19 patients has showed the correlation between clinical characteristics and cardiac injury of COVID-19. The high risk factors of cardiac injury including tachycardia, TnI elevation and low EAT density in CT scan, have been observed in the severe and critical COVID-19 patients. Our results suggested that the more attentions shall be applied to protect heart functions, particularly for those COVID-19 patients in severe and critical cases.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.02.24.20027052v1 on medRxiv