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ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Clinical and Translational Cardiovascular Medicine
Volume 12 - 2025 |
doi: 10.3389/fcvm.2025.1545142
Impact of Myocardial Injury on Cardiovascular Complications in Hospitalized Patients With COVID-19: Insights from Latin America
Provisionally accepted
Paula Andrea Cárdenas-Marín 1,2,3 Brayan Daniel Cordoba-Melo 1,2,3 Diana Cristina Carrillo-Gómez 2
Hoover León-Giraldo 1,3
Ivan J Mendoza 4 Noel Flórez 2 Ricardo Enrique Larrea Gómez 5 Jessica Mercedes 6
Cesar Herrera 7 Julián Lugo-Peña 8
Liliana Patricia Cárdenas-Aldaz 9
Victor Rossel 10 Ricardo Ramírez Ramírez 11 Hugo Fernando Fernández 12 Andrés Ulate Retana 13 J. Daniel Sierra-Lara Martinez 14
Estevão Lanna Figueiredo 15 Wilbert German Yabar Galindo 16
Miguel Angel Quintana Da Silva 17 Alexander Romero 18 Paula Silva 19 Armando Alvarado 20 Andrea Valencia 1
Juan Esteban Gomez-Mesa 1,2,21,3*- 1 Research Clinical Center ,Valle del Lili Foundation, Cali, Cauca, Colombia
- 2 Department of Cardiology, Valle del Lili Foundation, Cali, Cauca, Colombia
- 3 Faculty of Health Sciences, ICESI University, Cali, Cauca, Colombia
- 4 Institute of Tropical Medicine, Central University of Venezuela, Caracas, Venezuela
- 5 Department of Cardiology, Clinic Dávila, Santiago, Santiago Metropolitan Region (RM), Chile
- 6 Hospital Nacional Rosales, San Salvador, El Salvador
- 7 Centros de Diagnóstico y Medicina Avanzada y de Conferencias Médicas y Telemedicina (CEDIMAT), Santo Domingo, Distrito Nacional, Dominican Republic
- 8 Clínica del Occidente, Bogotá, Cundinamarca, Colombia
- 9 Hospital de Especialidades Eugenio Espejo, Quito, Pichincha, Ecuador
- 10 Department of Cardiology, Salvador Hospital, Santiago, Santiago Metropolitan Region (RM), Chile
- 11 Instituto Nacional del Tórax, Santiago, Santiago Metropolitan Region (RM), Chile
- 12 Clínica San Francisco, Tuluá, Colombia
- 13 Hospital México - Pozos, San José, Costa Rica
- 14 Unidad de Cuidados Coronarios, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, México, Mexico
- 15 Hospital Vera Cruz SA, Campinas, Brazil
- 16 Hospital Base Guillermo Almenara Irigoyen, Lima, Peru
- 17 Instituto Cardiovascular Sanatorio MIGONE, Asunción, Paraguay
- 18 Hospital Santo Tomas, Ciudad de Panamá, Panama
- 19 Fundacion Favaloro Hospital Universitario, Buenos Aires, Buenos Aires, Argentina
- 20 Hospital Especializado de Villa Nueva, Villa Nueva, Guatemala
- 21 Sociedad Interamericana de Cardiología, Ciudad de México, Mexico
Introduction: Viral infection by SARS-CoV2 is a pandemic affecting over 600 million people worldwide. One of five hospitalized patients may present myocardial injury, strongly associated with disease severity and mortality.Retrospective cross-sectional study of hospitalized COVID-19 patients diagnosed between May 01, 2020, and June 30, 2021, from the database of the Registro Latinoamericano de Enfermedad Cardiovascular y COVID-19 (CARDIO COVID 19-20) with a troponin value recorded during hospitalization. A descriptive analysis of sociodemographic and clinical characteristics was performed. Bivariate analysis was conducted according to the presence or absence of myocardial injury. Survival analysis was made using Kaplan-Meier curves, by the presence of myocardial injury. A multivariate Poisson regression model was performed to determine factors associated with mortality. Statistical analyses were performed using the RStudio V.1.4.1717 package.Results: A total of 2134 patients were included, 64.2% were male, and 911 patients had myocardial injury. The median age of the total population was 61 years. Individuals with myocardial injury had a higher prevalence of hypertension, diabetes, and dyslipidemia. Survival probability was lower in this subgroup. Patients with myocardial injury had a 1.95 times higher risk of death. Age, male sex, chronic kidney disease, arrhythmias, decompensated heart failure, requirement of inotropic / vasopressor, and invasive mechanical ventilation were related to higher mortality risk in patients with myocardial injury.Patients with COVID-19 and myocardial injury exhibit a broad spectrum of cardiac abnormalities. Myocardial injury is associated with a higher disease severity and risk of in-hospital mortality. This multicenter study uniquely represents data from 13 Latin American countries, offering regional insights into the impact of myocardial injury during the COVID-19 pandemic.
Keywords: Myocardial Injury1, Covid-192, Cardiovascular Complications3, Hospital Mortality4, Troponin Levels5
Received: 14 Dec 2024; Accepted: 26 Jan 2025.
Copyright: © 2025 Cárdenas-Marín, Cordoba-Melo, Carrillo-Gómez, León-Giraldo, Mendoza, Flórez, Larrea Gómez, Mercedes, Herrera, Lugo-Peña, Cárdenas-Aldaz, Rossel, Ramírez Ramírez, Fernández, Ulate Retana, Sierra-Lara Martinez, Lanna Figueiredo, Yabar Galindo, Quintana Da Silva, Romero, Silva, Alvarado, Valencia and Gomez-Mesa. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Juan Esteban Gomez-Mesa, Research Clinical Center ,Valle del Lili Foundation, Cali, Cauca, Colombia
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