Evidence map›Paper›PMID 32984929›Full record

ArticleInternal and emergency medicine2021

Cardiac injury and mortality in patients with Coronavirus disease 2019 (COVID-19): insights from a mediation analysis.

Alberto Cipriani, Federico Capone, Filippo Donato, Leonardo Molinari, Davide Ceccato, Alois Saller, Lorenzo Previato, Raffaele Pesavento, Cristiano Sarais, Paola Fioretto and 4 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Internal and emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 6 pooled it
0.8field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 6 syntheses or guidelines pooled it, 37 citations in OpenAlex.

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  3. Pre-existing atrial fibrillation is associated with increased mortality in COVID-19 Patients.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2021
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  8. Sex-Based Differences in Mitral Annular Disjunction Severity and Arrhythmic Risk in Mitral Valve Prolapse.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 1 institution in 1 country.

Alberto Cipriani *Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy. alberto.cipriani@unipd.it.ORCID http://orcid.org/0000-0001-7842-6202
Federico Capone *Department of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy.
Filippo DonatoDepartment of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy.
Leonardo MolinariDepartment of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy.
Davide CeccatoDepartment of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy.
Alois SallerDepartment of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy.
Lorenzo PreviatoDepartment of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy.
Raffaele PesaventoDepartment of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy.
Cristiano SaraisDepartment of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy.
Paola FiorettoDepartment of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy.
Sabino IlicetoDepartment of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy.
Dario GregoriDepartment of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy.
Angelo AvogaroDepartment of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy.
Roberto VettorDepartment of Medicine, University of Padova, Via Giustiniani, 2, Padua, 35128, Italy.
University of Padua · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundsPatients at greatest risk of severe clinical conditions from coronavirus disease 2019 (COVID-19) and death are elderly and comorbid patients. Increased levels of cardiac troponins identify patients with poor outcome. The present study aimed to describe the clinical characteristics and outcomes of a cohort of Italian inpatients, admitted to a medical COVID-19 Unit, and to investigate the relative role of cardiac injury on in-hospital mortality. METHODS AND

resultsWe analyzed all consecutive patients with laboratory-confirmed COVID-19 referred to our dedicated medical Unit between February 26th and March 31st 2020. Patients' clinical data including comorbidities, laboratory values, and outcomes were collected. Predictors of in-hospital mortality were investigated. A mediation analysis was performed to identify the potential mediators in the relationship between cardiac injury and mortality. A total of 109 COVID-19 inpatients (female 36%, median age 71 years) were included. During in-hospital stay, 20 patients (18%) died and, compared with survivors, these patients were older, had more comorbidities defined by Charlson comorbidity index ≥ 3(65% vs 24%, p = 0.001), and higher levels of high-sensitivity cardiac troponin I (Hs-cTnI), both at first evaluation and peak levels. A dose-response curve between Hs-cTnI and in-hospital mortality risk up to 200 ng/L was detected. Hs-cTnI, chronic kidney disease, and chronic coronary artery disease mediated most of the risk of in-hospital death, with Hs-cTnI mediating 25% of such effect. Smaller effects were observed for age, lactic dehydrogenase, and D-dimer.

conclusionsIn this cohort of elderly and comorbid COVID-19 patients, elevated Hs-cTnI levels were the most important and independent mediators of in-hospital mortality.

Indexed as

Hospital MortalityAgedCOVID-19FemaleHeart InjuriesHumansItalyMaleMediation AnalysisRisk FactorsSARS-CoV-2Cardiac injuryCardiac troponinCoronavirus 2019COVID-19

Identifiers

PMID32984929
PMCPMC7520162
OpenAlexW3089127038

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.