Cardiac injury in moderate and severe covid 19 pneumonia patients: role in prognosis

Background: Cardiac injury has now been a emerging complication of the ongoing pandemic of COVID 19.Increased risk of infection to the patients with cardiovascular disease were addressed in various studies however the risk of myocardial injury and subsequent complications and long term outcome after COVID 19 are of concern in coming years. Aims and objective: The aim of the study is to correlate the presence of cardiac injury and their clinical outcome in patients with moderate and severe COVID 19 pneumonia. Methods and Methodology: This was a prospective observational study done from March 2021 to July 2021, conducted in Chitwan Medical College and Teaching Hospital, Bharatpur, Nepal. Cardiac injury was defined by raised in cardiac biomarkers level, electrocardiographic changes and decrease in left ventricular ejection fraction. Results: In this study, total 44 patients were studied with a mean age of 54.59±12.58 years and age more than 50 years (72.7%) with male predominance (65.9%). Hypertension (29.5%) being the common risk factor in those patients. Significant difference was found in moderate and severe COVID 19 with WBC count, serum Potassium level, C-reactive protein, cardiac troponin I, D-Dimer (p<0.05). Sinus tachycardia was the most common ECG findings. Only 27.27% were able to transfer to ward, mortality during ICU stay observed in 47.72% of patients and 25% were discharged against the medical advice. There was significant difference in in-hospital mortality with the severity of COVID 19. Conclusion: Cardiac injury was common in patient with severe COVID 19 patients. Cardiac biomarkers as well as WBC count, serum potassium level, D-Dimer, CRP helps in prognosis of severity of COVID 19. Electrocardiogram(ECG) changes and in hospital mortality was observed more in severe COVID 19 patients.