IMPORTANCE Coronavirus disease 2019 (COVID-19) has resulted in considerable morbidity
and mortality worldwide since December 2019. However, information on cardiac injury in
patients affected by COVID-19 is limited.
OBJECTIVE To explore the association between cardiac injury and mortality in patients with
COVID-19.
DESIGN, SETTING, AND PARTICIPANTS This cohort study was conducted from January 20,
2020, to February 10, 2020, in a single center at Renmin Hospital of Wuhan University,
Wuhan, China; the final date of follow-up was February 15, 2020. All consecutive inpatients
with laboratory-confirmed COVID-19 were included in this study.
MAIN OUTCOMES AND MEASURES Clinical laboratory, radiological, and treatment data were
collected and analyzed. Outcomes of patients with and without cardiac injury were
compared. The association between cardiac injury and mortality was analyzed.
RESULTS A total of 416 hospitalized patients with COVID-19 were included in the final analysis;
the median age was 64 years (range, 21-95 years), and 211 (50.7%) were female. Common
symptoms included fever (334 patients [80.3%]), cough (144 [34.6%]), and shortness of
breath (117 [28.1%]). A total of 82 patients (19.7%) had cardiac injury, and compared with
patients without cardiac injury, these patients were older (median [range] age, 74 [34-95] vs
60 [21-90] years; P < .001); had more comorbidities (eg, hypertension in 49 of 82 [59.8%] vs
78 of 334 [23.4%]; P < .001); had higher leukocyte counts (median [interquartile range
(IQR)], 9400 [6900-13 800] vs 5500 [4200-7400] cells/μL) and levels of C-reactive protein
(median [IQR], 10.2 [6.4-17.0] vs 3.7 [1.0-7.3] mg/dL), procalcitonin (median [IQR], 0.27
[0.10-1.22] vs 0.06 [0.03-0.10] ng/mL), creatinine kinase–myocardial band (median [IQR], 3.2
[1.8-6.2] vs 0.9 [0.6-1.3] ng/mL), myohemoglobin (median [IQR], 128 [68-305] vs 39 [27-65]
μg/L), high-sensitivity troponin I (median [IQR], 0.19 [0.08-1.12] vs <0.006 [<0.006-0.009]
μg/L), N-terminal pro-B-type natriuretic peptide (median [IQR], 1689 [698-3327] vs 139
[51-335] pg/mL), aspartate aminotransferase (median [IQR], 40 [27-60] vs 29 [21-40] U/L),
and creatinine (median [IQR], 1.15 [0.72-1.92] vs 0.64 [0.54-0.78] mg/dL); and had a higher
proportion of multiple mottling and ground-glass opacity in radiographic findings (53 of 82
patients [64.6%] vs 15 of 334 patients [4.5%]). Greater proportions of patients with cardiac
injury required noninvasive mechanical ventilation (38 of 82 [46.3%] vs 13 of 334 [3.9%];
P < .001) or invasive mechanical ventilation (18 of 82 [22.0%] vs 14 of 334 [4.2%]; P < .001)
than those without cardiac injury. Complications were more common in patients with cardiac
injury than those without cardiac injury and included acute respiratory distress syndrome (48
of 82 [58.5%] vs 49 of 334 [14.7%]; P < .001), acute kidney injury (7 of 82 [8.5%] vs 1 of 334
[0.3%]; P < .001), electrolyte disturbances (13 of 82 [15.9%] vs 17 of 334 [5.1%]; P = .003),
hypoproteinemia (11 of 82 [13.4%] vs 16 of 334 [4.8%]; P = .01), and coagulation disorders (6
of 82 [7.3%] vs 6 of 334 [1.8%]; P = .02). Patients with cardiac injury had higher mortality
than those without cardiac injury (42 of 82 [51.2%] vs 15 of 334 [4.5%]; P < .001). In a Cox
regression model, patients with vs those without cardiac injury were at a higher risk of death,
both during the time from symptom onset (hazard ratio, 4.26 [95% CI, 1.92-9.49]) and from
admission to end point (hazard ratio, 3.41 [95% CI, 1.62-7.16]).
CONCLUSIONS AND RELEVANCE Cardiac injury is a common condition among hospitalized
patients with COVID-19 in Wuhan, China, and it is associated with higher risk of in-hospital
mortality.

Submit your work at https://www.scitechnol.com/submission/ or send an e-mail attachment to the Editorial Office or  pharmasci@scitecjournals.com
Please provide me your acceptance for the same!
Best Regards,
Editorial Assistant
Journal of Pharmaceutical Sciences & Emerging Drugs
E-mail:  editor.jpsed@scitechnol.com 
What’sapp No.: +1-579-679-8957