Evaluation of Myocardial Injury Patterns and ST Changes among Critical and Non-critical Patients with Coronavirus-19 Disease

Background: Novel coronavirus disease (COVID-19) has led to a major public health crisis globally. Currently, myocardial damage is speculated to be associated with COVID-19, which can be seen as one of the main causes of death of patients with COVID-19. Therefore, in this study, we aim to investigate the effects of COVID-19 diagnosed patients on myocardial injury. Methods: A prospective study was conducted among 201 patients with COVID-19 in the Pakistan Military Hospital from April 1 to August 31, 2020, including non-critical cases and critical cases. COVID-19 patients were stratified as critical and non-critical according to signs and symptoms with those requiring intensive care and ventilator support as critical and those don’t require ventilator support as non-critical Results: : A total of 201 COVID-19 patients with critical and non-critical categories presented with myocardial injury. All patients with myocardial injury had an elevation in CKMB and Trop 1 levels. Of these patients, 43.7% presented with new electrocardiography (ECG) changes, ST depression is observed in 36.3% patients, and 16.9% presented with abnormal electrocardiogram findings, with right ventricular dilatation and dysfunction. Results analyzed by a logistic regression model showing COVID-19 direct contribution to myocardial injury in these patients. Conclusion: COVID-19 disease directly leads to cardiovascular damage among critical and non-critical patients. Myocardial injury is associated not only with abnormal ECG changes but also with myocardial dysfunction on echocardiography and more commonly observed among critical patients.