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 < 0.001); had more comorbidities (e.g., hypertension in 49 of 82 [59.8%] vs. 78 of 334 [23.4%]; p < 0.001); 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 < 0.001) or invasive mechanical ventilation (18 of 82 [22.0%] vs. 14 of 334 [4.2%]; p < 0.001) 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 < 0.001), acute kidney injury (7 of 82 [8.5%] vs. 1 of 334 [0.3%]; p < 0.001), electrolyte disturbances (13 of 82 [15.9%] vs. 17 of 334 [5.1%]; p = 0.003), hypoproteinemia (11 of 82 [13.4%] vs. 16 of 334 [4.8%]; p = 0.01), and coagulation disorders (6 of 82 [7.3%] vs. 6 of 334 [1.8%]; p = 0.02). Patients with cardiac injury had higher mortality than those without cardiac injury (42 of 82 [51.2%] vs. 15 of 334 [4.5%]; p < 0.001). In a Cox regression model, patients with versus those without cardiac injury were at a higher risk of death, both during the time from symptom onset (hazard ratio [HR], 4.26; 95% confidence interval [CI], 1.92-9.49) and from admission to endpoint (HR, 3.41; 95% CI, 1.62-7.16).