Background
Acute myocardial injury is
associated with poor prognosis in respiratory tract infections. We aimed to
highlight the differences in prevalence of myocardial injury and its impact on
prognosis in patients with COVID-19 compared to those with seasonal influenza.
Methods
This was a single-center
prospective cohort study with a historical control group. 300 age-/sex-matched
SARS-CoV-2 and seasonal influenza positive patients were enrolled. Myocardial injury was assessed by
electrocardiogram (ECG), transthoracic echocardiography and biomarkers
including high-sensitivity troponin-I. All patients were followed-up for 30
days after enrollment for all-cause mortalitiy, admission to the intensive care
unit (ICU) and mechanical ventilation.
Results
Right ventricular distress
was more common in COVID-19 whereas pathological ECG findings and impaired left ventricular function were more
prevalent among influenza patients. COVID-19 patients suffered from a higher
percentage of hypertension and dyslipidaemia. Contrary to COVID-19, pericardial
effusion at admission was associated with poor
outcome in
the influenza group. Severe course of disease and respiratory failure resulted
in significantly higher rates of ICU treatment and mechanical ventilation in
COVID-19 patients. Although distribution of myocardial injury was similar,
significantly fewer cardiac catheterizations were performed in COVID-19
patients. However, number of cardiac catheterizations was low in both groups.
Finally, 30-day mortality was significantly higher in COVID-19 compared to
influenza patients (Figure 1).
Conclusions
In adults requiring
hospitalization due to COVID-19 or seasonal influenza, cardiovascular risk
factors and signs of myocardial distress differ significantly. Furthermore,
cardiovascular comorbidities may impair prognosis in COVID-19 patients to a
higher degree than in their influenza counterparts.