Frequency and prognosis of CVD and myocardial injury in patients presenting with suspected COVID-19 – The CoV-COR registry
Background: The COVID-19 pandemic led to an alteration of algorithms in emergency medicine, which may influence the management of patients with similar symptoms but underlying cardiovascular diseases. We evaluated key differential diagnoses to acute COVID-19 infection and the prevalence and the prog...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906723000155 |
| _version_ | 1797854512669523968 |
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| author | Amir A. Mahabadi Raluca Mincu Iryna Dykun Lars Michel Alexander Küng Oliver Witzke Clemens Kill Jan Buer Tienush Rassaf Matthias Totzeck |
| author_facet | Amir A. Mahabadi Raluca Mincu Iryna Dykun Lars Michel Alexander Küng Oliver Witzke Clemens Kill Jan Buer Tienush Rassaf Matthias Totzeck |
| author_sort | Amir A. Mahabadi |
| collection | DOAJ |
| description | Background: The COVID-19 pandemic led to an alteration of algorithms in emergency medicine, which may influence the management of patients with similar symptoms but underlying cardiovascular diseases. We evaluated key differential diagnoses to acute COVID-19 infection and the prevalence and the prognosis of myocardial injury in patients presenting for suspected COIVD-19 infection. Methods: This prospective observational study includes patients presenting with symptoms suggestive of COVID-19 infection during the pandemic. In patients without COVID-19, leading diagnoses was classified according to ICD-10. Myocardial injury was defined as elevated high-sensitivity Troponin I with at least one value above the 99th percentile upper reference limit and its prevalence together with 90-days mortality rate was compared in patients with vs without COVID-infection. Results: From 497 included patients (age 62.9 ± 17.2 years, 56 % male), 314 (63 %) were tested positive on COVID-19 based on PCR-testing, while another cause of symptom was detected in 183 patients (37 %). Cardiovascular diseases were the most frequent differential diagnoses (40 % of patients without COVID-19), followed by bacterial infection (24 %) and malignancies (16 %). Myocardial injury was present in 91 patients (COVID-19 positive: n = 34, COVID-19 negative: n = 57). 90-day mortality rate was higher in patients with myocardial injury (13.4 vs 4.6 %, p = 0.009). Conclusion: Cardiovascular diseases represent the most frequent differential diagnoses in patients presenting to a tertiary care emergency department with symptoms suggestive of an acute infection. Screening for cardiovascular disease is crucial in the initial evaluation of symptomatic patients during the COVID pandemic to identify patients at increased risk.Trial Registration: Clinicaltrials.gov Identifier: NCT04327479. |
| first_indexed | 2024-04-09T20:07:15Z |
| format | Article |
| id | doaj.art-1863dd1034124b148c2cc5d1150c5149 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-04-09T20:07:15Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-1863dd1034124b148c2cc5d1150c51492023-04-01T08:50:21ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672023-04-0145101184Frequency and prognosis of CVD and myocardial injury in patients presenting with suspected COVID-19 – The CoV-COR registryAmir A. Mahabadi0Raluca Mincu1Iryna Dykun2Lars Michel3Alexander Küng4Oliver Witzke5Clemens Kill6Jan Buer7Tienush Rassaf8Matthias Totzeck9West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany; Corresponding author.West German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, GermanyWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, GermanyWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, GermanyWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, GermanyDepartment of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, Hufelandstr. 55, 45147 Essen, GermanyCenter of Emergency Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germanythe Institute of Medical Microbiology, University Hospital Essen, Hufelandstr. 55, 45147 Essen, GermanyWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, GermanyWest German Heart and Vascular Center Essen, Department of Cardiology and Vascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, GermanyBackground: The COVID-19 pandemic led to an alteration of algorithms in emergency medicine, which may influence the management of patients with similar symptoms but underlying cardiovascular diseases. We evaluated key differential diagnoses to acute COVID-19 infection and the prevalence and the prognosis of myocardial injury in patients presenting for suspected COIVD-19 infection. Methods: This prospective observational study includes patients presenting with symptoms suggestive of COVID-19 infection during the pandemic. In patients without COVID-19, leading diagnoses was classified according to ICD-10. Myocardial injury was defined as elevated high-sensitivity Troponin I with at least one value above the 99th percentile upper reference limit and its prevalence together with 90-days mortality rate was compared in patients with vs without COVID-infection. Results: From 497 included patients (age 62.9 ± 17.2 years, 56 % male), 314 (63 %) were tested positive on COVID-19 based on PCR-testing, while another cause of symptom was detected in 183 patients (37 %). Cardiovascular diseases were the most frequent differential diagnoses (40 % of patients without COVID-19), followed by bacterial infection (24 %) and malignancies (16 %). Myocardial injury was present in 91 patients (COVID-19 positive: n = 34, COVID-19 negative: n = 57). 90-day mortality rate was higher in patients with myocardial injury (13.4 vs 4.6 %, p = 0.009). Conclusion: Cardiovascular diseases represent the most frequent differential diagnoses in patients presenting to a tertiary care emergency department with symptoms suggestive of an acute infection. Screening for cardiovascular disease is crucial in the initial evaluation of symptomatic patients during the COVID pandemic to identify patients at increased risk.Trial Registration: Clinicaltrials.gov Identifier: NCT04327479.http://www.sciencedirect.com/science/article/pii/S2352906723000155COVID-infectionMyocardial injuryCardiovascular diseasesEmergency department |
| spellingShingle | Amir A. Mahabadi Raluca Mincu Iryna Dykun Lars Michel Alexander Küng Oliver Witzke Clemens Kill Jan Buer Tienush Rassaf Matthias Totzeck Frequency and prognosis of CVD and myocardial injury in patients presenting with suspected COVID-19 – The CoV-COR registry International Journal of Cardiology: Heart & Vasculature COVID-infection Myocardial injury Cardiovascular diseases Emergency department |
| title | Frequency and prognosis of CVD and myocardial injury in patients presenting with suspected COVID-19 – The CoV-COR registry |
| title_full | Frequency and prognosis of CVD and myocardial injury in patients presenting with suspected COVID-19 – The CoV-COR registry |
| title_fullStr | Frequency and prognosis of CVD and myocardial injury in patients presenting with suspected COVID-19 – The CoV-COR registry |
| title_full_unstemmed | Frequency and prognosis of CVD and myocardial injury in patients presenting with suspected COVID-19 – The CoV-COR registry |
| title_short | Frequency and prognosis of CVD and myocardial injury in patients presenting with suspected COVID-19 – The CoV-COR registry |
| title_sort | frequency and prognosis of cvd and myocardial injury in patients presenting with suspected covid 19 the cov cor registry |
| topic | COVID-infection Myocardial injury Cardiovascular diseases Emergency department |
| url | http://www.sciencedirect.com/science/article/pii/S2352906723000155 |
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