Table 2 Characteristics and outcomes of retrieved trials for the outcome “Acute cardiac injury” and “Acute myocardial infarction”
From: Cardiac complications in patients with COVID-19: a systematic review
Acute cardiac injuryΔ | ||||||||||||
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Authors | Age (years) all patients | Age (years) treatment group | Age (years) control group | Sex M/F+ | Cardiological comorbidities (n° pts) | Other comorbidities (n° pts) | COVID-19 severity | Acute cardiac injury (n° pts or cases-controls) | Troponin T or I value—BNP or NT-proBNP valueπ | LVEDV – EF (n° pts or cases-controls)π | Other no cardiac complications (n° pts) | Outcome (n° pts or cases-controls) |
Bangalore et al. [13] | 63 (54–73)§ | 60 (56–73)§ | 66 (54–73)§ | 15/3 | Hypertension (11) Diabetes (6) Dyslipidemia (7) Smoking (1) Coronary heart disease (3) | Chronic kidney disease (1) | NA | 10 | TnI 13.5 (4.8–41) ng/ml§ TnT 0.02 ng/ml§ | Not reported (2) | NA | Death (4-9) |
Cao et al. [15] | 54 (37–67)§ | 66 (54–76)§ | 31 (35–62)§ | 53/49 | Hypertension (28) Diabetes (11) Cardiovascular disease (5) Cerebrovascular diseases (6) | Respiratory diseases (10) Malignancy (4) Chronic kidney disease (4) Chronic liver disease (2) | Patients subjected to mechanical ventilation, ECMO, and CRRT | 6–9 | NA | NA | Shock (10) ARDS (20) Acute infections (17) Acute kidney damage (20) Chronic kidney damage (34) ECMO (3) Mechanical ventilation (7) CRRT (4) | Death (6-11) Discharge (12-73) |
Chen et al. [16] | 57.6 (44.9–70.3)§ | 56.1 ± 13.5° | 61.7 ± 9.6° | 36/18 | Hypertension (16) Diabetes (25) Coronary heart disease (6) | NA | Severe condition if: Respiratory distress, RR > 30 acts/min or SpO2 < 93% rest or P/F < 300 Critical condition if: Mechanical ventilation or shock or failure of other organs that requires intensive monitoring and treatment | 0–3 | TnI 0.29 ± 0.68 ng/ml° NT-proBNP 1582 ± 2374 pg/ml° | NA | AKI (18) | NA |
Chen et al. [17] | 62 (44–70)§ | 68 (62–77)§ | 51 (37–66)§ | 171/103 | Hypertension (93) Smoke (12) Diabetes (47) Cardiovascular disease (23) Chronic heart failure (1) Cerebrovascular disease (4) | Chronic lung disease (18) Malignancy (7) Chronic kidney disease (4) Autoimmune disease (2) | According to the China Guidance for Corona Virus Disease 2019 (6th edition) | 72–18 | NA | NA | ARDS (192) Sepsis (179) AKI (29) DIC (21) Shock (46) Acute liver injury (13) Mechanical ventilation (119) CRRT (3) ECMO (1) | Death (113) Recovered (161) |
Du et al. [22] | 65.8 ± 14.2° | NA | NA | 62/23 | Hypertension (32) Diabetes (19) Coronary heart disease (10) Cerebrovascular diseases (7) | Chronic liver disease (5) Chronic kidney disease (3) COPD (2) Malignancy (6) | On the recommendations by the National Institute for Viral Disease Control and Prevention, China (fifth edition) | 38 | NA | NA | Respiratory failure (80) Shock (69) ARDS (63) Acute liver injury (38) Sepsis (28) | Death (51) |
Guo et al. [25] | 58.5 (14.66)° | 53.53 (13.22)° | 34 (65.4)° | 91/96 | Smoking (18) Hypertension (61) Coronary heart disease (21) Cardiomyopathy (8) Diabetes (28) | COPD (4) Malignancy (13) Chronic kidney disease (6) | NA | 135–52 | NT-proBNP 268.4 (75.3–689.1)§ | NA | ARDS (46) Acute coagulopathy (42) Liver injury (19) Kidney injury (18) Mechanical ventilation (45) | Death (12-31) |
Huang et al. [27] | 49 (41–58)§ | 49 (41–61)§ | 49 (41–57.5)§ | 30/11 | Smoke (3) Hypertension (6) Diabetes (8) Cardiovascular disease (6) | COPD (1) Malignancy (1) Chronic liver disease (1) | Patients developed ARDS, requiring ICU admission and oxygen therapy | 4-1 | TnI > 28 pg/ml | NA | Pneumonia (41) ARDS (12) AKI (3) Secondary infection (4) Shock (3) CRRT (3) NIV (10) Invasive mechanical ventilation (2) ECMO (2) | Death (6) Discharge (28) |
Ruan et al. [39] | NA | 67 (15–81)§ | 50 (44–81)§ | 102/48 | Hypertension (52) Cardiovascular disease (13) Diabetes (25) Cerebrovascular disease (12) | COPD (3) Chronic kidney disease (2) Malignancy (3) Chronic liver disease (4) | NA | 27 | NA | NA | Respiratory failure (71) ARDS (62) AKI (23) Infection (12) Mechanical ventilation (25) ECMO (7) CRRT (5) | Death (68) Discharged (82) |
Shao et al. [42] | 73.5 (29–66)§ | NA | NA | 13/5 | Hypertension (10) Diabetes (4) Cerebrovascular disease (5) | Renal disease (3) Malignancy (2) COPD (2) HIV (1) Autoimmune disease (1) | Based on The National Health Commission of China Guidelines (7th edition) | 10 | NA | NA | ARDS (17) Invasive mechanical ventilation (11) CRRT (7) AKI (7) Shock (6) ECMO (1) Gastrointestinal bleeding (1) Perforation of the intestine (1) Co-infection (5) | Death (10) |
Kunal et al. [32]. | 51.2 ± 17.7° | 60.9 ± 15.1° | 47.9 ± 17.4° | 70/38 | Hypertension (41) Diabetes (35) Cardiovascular disease (14) Dyslipidemia (6) Heart failure (1) | COPD (6) | NA | 28–80 | TnT 0.66 ± 1.28° mcg/L | NA | Sepsis (25) ARDS (12) AKI (8) Diabetic ketoacidosis (3) Intracranial hemorrhage (1) | Death (16-14) |
Shi et al. [43] | 64 (21–95)§ | 74 (34–95)§ | 60 (21–90)§ | 205/211 | Hypertension (127) Diabetes (60) Coronary heart disease (44) Cerebrovascular disease (22) Chronic heart failure (17) | chronic kidney disease (14) COPD (12) Malignancy (9) Hepatitis B infection (4) | NA | 82–334 | Hs TnI 0,19 (0.08–1.12) mcg/L§ NT-proBNP 1689 (698–3327) pg/ml§ | NA | Noninvasive ventilation (51) Invasive mechanical ventilation (32) CRRT (2) ARDS (97) AKI (8) | Death (42-15) Discharge (2-38) Recovered (38-281) |
Shi et al. [44] | 63 (50–72)§ | 73 (66–80)§ | 57 (43–70)§ | 322/349 | Hypertension (199) Diabetes (97) Coronary heart disease (60) Chronic heart failure (22) Cerebrovascular disease (22) Atrial fibrillation (7) | Chronic renal disease (28) COPD (23) Cancer (23) | Severe and critical diseases are defined by the presence of any of RR > 30 acts/min; oxygen saturation ≤ 93%; PaO2/FiO2 ratio < 300 mmHg; respiratory failure requiring mechanical ventilation; shock; respiratory failure with other organ failure requiring ICU management | 106 | TnI 0.159 (0.075–0.695) ng/ml§ NT-proBNP 1346 (474–3018) pg/ml§ | NA | Invasive mechanical ventilation (36) ECMO (2) CRRT (4) | Death (62) Survivors (609) |
Szekely et al. [47] | 66.1 ± 17.3° | 65.9 ± 20° | 69.8 ± 16° | 63/37 | Hypertension (57) Ischemic heart disease (16) Congestive heart failure (7) Cerebrovascular disease (11) Atrial fibrillation (715) | Chronic renal disease (10) Diabetes (29) Obesity (29) Asthma (7) Malignancy (5) | Acuity score | Troponin level above the 99th percentile was reported in 20% of the patients | Tn I 11 (5–39) ng/L§ BNP 43 (18–144) pg/L§ | EF 58.2 ± 4° | NA | NA |
Tavazzi et al. [48] | 69+ | NA | NA | 1/0 | NA | NA | NA | 1 | NA | LVEDV 56 mm+ EF 34%+ | Bilateral interstitial pneumonia (1) Mechanical ventilation (1) IABP (1) ECMO (1) Septic shock (1) | Death (1) |
Wan et al. [50] | 47 (36–55)§ | 44 (33–49)§ | 56 (52–73)§ | 72/63 | Current smoking (9) Diabetes (12) Hypertension (13) | Malignancy (4) Pulmonary disease (1) Chronic liver disease (2) | The mild group had mild symptoms and no pneumonia; the normal group had fever, respiratory symptoms, and pneumonia; the severe group had respiratory distress, RR ≥ 3acts/min at rest, mean oxygen saturation ≤ 93%, and P/F ≤ 300 mmHg; the critical group had respiratory failure with mechanical ventilation, shock, and other failures, requiring ICU treatment | 8-2 | NA | NA | ARDS (21) AKI (5) Secondary infection (7) Shock (1) CRRT (5) Invasive mechanical ventilation (1) | Death (0-1) Discharge (10-5) Hospitalization (85-35) |
Xiong et al. [52] | 58.5 (47–69)§ | 56 (37–64)§ | 64 (53–76)§ | 80/63 | Diabetes (19) Hypertension (45) Coronary Heart Disease (17) Cardiovascular disease (8) | COPD (1) Malignancy (4) Chronic liver disease (2) | Moderate cases: mild respiratory symptoms with pneumonia Severe cases: dyspnea, RR ≥ 30/min, blood oxygen saturation ≤ 93%, PaO2/FiO2 ratio ≤ 300 mmHg, and/or pulmonary inflammation progressing > 50% within 24 to 48 h. Critical cases: respiratory failure, shock, and/or multiple organ dysfunction | 4–19 | TnT > 0.02 ng/ml+ NT-proBNP 71.5 (27–363.5)§ pg/ml | NA | Shock (16) ARDS (20) Liver dysfunction (15) AKI (3) Invasive mechanical ventilation (10) ECMO (3) | Discharge (61-48) Death (0-7) |
Yang et al. [53] | 59.7 (13,3)° | 51,9 (12.9)° | 64.6 (11.2)° | 14/6 | Chronic cardiac disease (5) Cerebrovascular disease (7) Diabetes (9) Smoke (2) | Chronic pulmonary disease (4) Malignancy (2) | Admission to ICU requiring mechanical ventilation or FiO2 ≥ 60% | 3–9 | TnI > 28 pg/ml | NA | ARDS (35) AKI (15) Liver dysfunction (15) Hospital-acquired pneumonia (6) Invasive mechanical ventilation (22) ECMO (6) CRRT (9) | Death (32) Discharge (20) |
Yu et al. [54] | 64 (57–70)§ | NA | NA | 139/87 | Hypertension (96) Coronary heart disease (22) Myocardial infarction (6) Congestive heart failure (4) Diabetes (47) Cerebrovascular disease (15) | Chronic pulmonary disease (15) Chronic hepatopathy (3) Chronic nephrosis (8) Malignancy (10) | RR > 40 acts/min, PaO2 < 60 mmHg, SpO2 < 90% with oxygen support of ≥7 L/min for at least 30 min, PaCO2 > 50 mmHg, hemodynamic instability, use of vasopressors, GCS ≤ 12, CRRT | 61 | TnI > 0.3 ng/mL | NA | ARDS (161) Shock (36) AKI (57) Bacterial or fungal infection (49) Gastrointestinal hemorrhage (7) | Death (9) Discharge from ICU (13) ICU (204) |
Zhang et al. [56] | 55 (39–66.5)§ | 62 (52–74)§ | 51 (36–64.3)§ | 108/113 | Hypertension (54) Diabetes (22) Cardiovascular disease (22) Cerebrovascular disease (15) | COPD (6) Chronic kidney disease (6) Chronic liver disease (7) Malignancy (9) | Admission in ICU | 16-1 | NA | NA | ARDS (48) Shock (15) AKI (10) CRRT (5) Mechanical ventilation (16) ECMO (10) | Death (12-0) Discharge (7-35) Hospitalization (36-131) |
Zhao et al. [57] | 46§ | 50.5§ | 42§ | 49/42 | Hypotension (18) Diabetes (3) | COPD (1) Autoimmune disease (1) Kidney disease (1) Malignancy (3) | NA | 8–6 | NA | NA | Pneumonia (91) Digestive tract disease (14) Liver disease (18) Renal disease (5) Coagulopathy (19) Mechanical ventilation (5) CRRT (3) | Death (2-0) Discharge (14-2) Hospitalization (26-49) |
Zhou et al. [58] | 56 (46–67)§ | 69 (63–76)§ | 52 (45–58)§ | 119/72 | Hypertension (58) Diabetes (36) Coronary heart disease (15) | COPD (6) Carcinoma (2) Chronic kidney disease (2) | NA | 32-1 | TnI > 28 pg/ml | NA | Sepsis (112) Respiratory failure (103) ARDS (59) Invasive mechanical ventilation (32) Coagulopathy (37) Septic shock (38) Acute kidney injury (28) ECMO (3) CRRT (10) Secondary infection (28) | Death (54) Discharged (137) |
Acute myocardial infarction | ||||||||||||
Authors | Age (years) all patients | Age (years) treatment group | Age (years) control group | Sex M/F+ | Cardiological comorbidities (n° pts) | Other comorbidities (n° pts) | COVID-19 severity | EKG (n° pts) | Coronarography/PCI (n° pts or cases-controls) | Troponin T or I value -BNP or NT-proBNP valueπ | Other no cardiac complications (n° pts) | Outcome (n° pts or cases-controls) |
Bangalore et al. [13] | 63 (54–73)§ | 60 (56-73)§ | 66 (54-73)§ | 15/3 | Hypertension (11) Diabetes (6) Dyslipidemia (7) Smoking (1) Coronary heart disease (3) | Chronic kidney disease (1) | NA | STEMI (8) | 6/5–3/0 | TnT 6.3 (5.3–7.2) ng/ml§ TnI 91 (65.5–345) ng/ml§ | NA | Death (4-9) |
Barton et al .[14] | 77/42+ | 77 | 42 | 2/0 | Hypertension (2) Obesity (2) Coronary heart disease (2) Dilated cardiopathy (1) | Oncocytoma (1) Prostate hyperplasia (1) Muscular dystrophy (1) Cirrhosis (1) Nephrosclerosis (1) | NA | NA | NA | NA | ARDS (1) Liver failure (1) Pneumonia ab ingestis (1) | Death (2) |
Dominguez-Erquicia et al. [20] | 64+ | NA | NA | 1/0 | NA | NA | NA | STEMI (1) | 1/1 | NA | Bilateral pneumonia (1) | Discharge (1) |
Dweck et al. [24] | 62 (52–71)§ | 64 (53–73)§ | 60 (51–69)§ | 844/365 | Hypertension (445) Diabetes (233) Ischemic heart disease (167) Heart failure (113) Valvular disease (80) | NA | Patients in critical care setting (ICU, coronary care unit, emergency room, cardiac catheter laboratory) | Not reported (27) STEMI (8) | NA | NA | NA | NA |
Kim HN et al. [30] | 60+ | NA | NA | 1/0 | Hypertension (1) Diabetes (1) Dyslipidemia (1) | NA | Mechanical oxygenation supports | STEMI (1) | 1/1 | TnI 46.1 ng/ml+ NT-proBNP 1971.5 pg/ml+ | Bilateral infiltration (1) Mechanical ventilation (1) CRRT (1) ECMO (1) | Death (1) |
Kunal et al. [32] | 51.2 ± 17.7° | 60.9 ± 15.1° | 47.9 ± 17.4° | 70/38 | Hypertension (41) Diabetes (35) Cardiovascular disease (14) Dyslipidemia (6) Heart failure (1) | COPD (6) | NA | STEMI (3) NSTEMI (1) | NA | NA | Sepsis (25) ARDS (12) AKI (8) Diabetic ketoacidosis (3) Intracranial hemorrhage (1) | Death (16-14) |
Stefanini et al. [46] | 68 ± 11° | NA | NA | 20/8 | Hypertension (20) Diabetes (9) Previous myocardial infarction (3) | Chronic kidney disease (8) | NA | STEMI (25) New LBBB (3) | 28/17 | NA | NA | Death (11) Discharge (16) ICU (1) |