Evidence map›Paper›PMID 33186055›Full record

ArticleCirculation2021

Myocardial Injury in Severe COVID-19 Compared With Non-COVID-19 Acute Respiratory Distress Syndrome.

Thomas S Metkus, Lori J Sokoll, Andreas S Barth, Matthew J Czarny, Allison G Hays, Charles J Lowenstein, Erin D Michos, Eric P Nolley, Wendy S Post, Jon R Resar and 3 more

Open access · bronzeAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed, 5 pooled it
3.0field-weighted citation impact, top 5% 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

91 citing papers in PubMed, 5 syntheses or guidelines pooled it, 157 citations in OpenAlex.

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  4. Prognostic performance of troponin in COVID-19: A diagnostic meta-analysis and meta-regression.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2021
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31 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 1 institution in 2 countries.

Thomas S MetkusDivisions of Cardiology (T.S.M., A.S.B., M.J.C., A.G.H., C.J.L., E.D.M., W.S.P., J.R.R., D.R.T., J.C.T., R.K.H.), Johns Hopkins University School of Medicine, Baltimore, MD.
Lori J SokollDepartment of Medicine, and Department of Pathology (L.J.S.), Johns Hopkins University School of Medicine, Baltimore, MD.
Andreas S BarthDivisions of Cardiology (T.S.M., A.S.B., M.J.C., A.G.H., C.J.L., E.D.M., W.S.P., J.R.R., D.R.T., J.C.T., R.K.H.), Johns Hopkins University School of Medicine, Baltimore, MD.
Matthew J CzarnyDivisions of Cardiology (T.S.M., A.S.B., M.J.C., A.G.H., C.J.L., E.D.M., W.S.P., J.R.R., D.R.T., J.C.T., R.K.H.), Johns Hopkins University School of Medicine, Baltimore, MD.
Allison G HaysDivisions of Cardiology (T.S.M., A.S.B., M.J.C., A.G.H., C.J.L., E.D.M., W.S.P., J.R.R., D.R.T., J.C.T., R.K.H.), Johns Hopkins University School of Medicine, Baltimore, MD.
Charles J LowensteinDivisions of Cardiology (T.S.M., A.S.B., M.J.C., A.G.H., C.J.L., E.D.M., W.S.P., J.R.R., D.R.T., J.C.T., R.K.H.), Johns Hopkins University School of Medicine, Baltimore, MD.
Erin D MichosDivisions of Cardiology (T.S.M., A.S.B., M.J.C., A.G.H., C.J.L., E.D.M., W.S.P., J.R.R., D.R.T., J.C.T., R.K.H.), Johns Hopkins University School of Medicine, Baltimore, MD.
Eric P NolleyPulmonary and Critical Care Medicine (E.P.N.), Johns Hopkins University School of Medicine, Baltimore, MD.
Wendy S PostDivisions of Cardiology (T.S.M., A.S.B., M.J.C., A.G.H., C.J.L., E.D.M., W.S.P., J.R.R., D.R.T., J.C.T., R.K.H.), Johns Hopkins University School of Medicine, Baltimore, MD.
Jon R ResarDivisions of Cardiology (T.S.M., A.S.B., M.J.C., A.G.H., C.J.L., E.D.M., W.S.P., J.R.R., D.R.T., J.C.T., R.K.H.), Johns Hopkins University School of Medicine, Baltimore, MD.
David R ThiemannDivisions of Cardiology (T.S.M., A.S.B., M.J.C., A.G.H., C.J.L., E.D.M., W.S.P., J.R.R., D.R.T., J.C.T., R.K.H.), Johns Hopkins University School of Medicine, Baltimore, MD.
Jeffrey C TrostDivisions of Cardiology (T.S.M., A.S.B., M.J.C., A.G.H., C.J.L., E.D.M., W.S.P., J.R.R., D.R.T., J.C.T., R.K.H.), Johns Hopkins University School of Medicine, Baltimore, MD.
Rani K HasanDivisions of Cardiology (T.S.M., A.S.B., M.J.C., A.G.H., C.J.L., E.D.M., W.S.P., J.R.R., D.R.T., J.C.T., R.K.H.), Johns Hopkins University School of Medicine, Baltimore, MD.
Johns Hopkins University · US

Funding

Institutional Career Development CoreKL2TR003099 · NCATS · JOHNS HOPKINS UNIVERSITY · PI GEBO, KELLY A · 2019 to 2023
$7.9M
Population genomic variation, functional biology, and the risk of venous thrombosisR01HL134894 · NHLBI · UNIVERSITY OF WASHINGTON · PI LOWENSTEIN, CHARLES J, SMITH, NICHOLAS L · 2017 to 2020
$2.9M
Model system of oral contraceptive-induced VTE: integrating genomic, transcriptomic, and proteomic discovery with functional biologyR33HL141791 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI LOWENSTEIN, CHARLES J, SMITH, NICHOLAS L · 2020 to 2022
$2.0M
Emerging factors in the pathophysiology of endothelial dysfunction in HIV+ womenR01HL147660 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI HAYS, ALLISON G · 2019 to 2023
$1.4M
NCATS NIH HHS KL2 TR003099NHLBI NIH HHS R01 HL134894NHLBI NIH HHS R01 HL147660NHLBI NIH HHS R33 HL141791
6 · The paper itself

Abstract

backgroundKnowledge gaps remain in the epidemiology and clinical implications of myocardial injury in coronavirus disease 2019 (COVID-19). We aimed to determine the prevalence and outcomes of myocardial injury in severe COVID-19 compared with acute respiratory distress syndrome (ARDS) unrelated to COVID-19.

methodsWe included intubated patients with COVID-19 from 5 hospitals between March 15 and June 11, 2020, with troponin levels assessed. We compared them with patients from a cohort study of myocardial injury in ARDS and performed survival analysis with primary outcome of in-hospital death associated with myocardial injury. In addition, we performed linear regression to identify clinical factors associated with myocardial injury in COVID-19.

resultsOf 243 intubated patients with COVID-19, 51% had troponin levels above the upper limit of normal. Chronic kidney disease, lactate, ferritin, and fibrinogen were associated with myocardial injury. Mortality was 22.7% among patients with COVID-19 with troponin under the upper limit of normal and 61.5% for those with troponin levels >10 times the upper limit of normal (

conclusionsMyocardial injury in severe COVID-19 is a function of baseline comorbidities, advanced age, and multisystem organ dysfunction, similar to traditional ARDS. The adverse prognosis of myocardial injury in COVID-19 relates largely to multisystem organ involvement and critical illness.

Indexed as

COVID-19Heart InjuriesRegistriesRespiratory Distress SyndromeAgedDisease-Free SurvivalFemaleHumansMaleMiddle AgedMyocardiumPrevalenceRespiration, ArtificialSARS-CoV-2Severity of Illness IndexSurvival RateTroponinCOVID-19respiratory distress syndrometroponin

Identifiers

PMID33186055
PMCPMC7864609
OpenAlexW3098601672

What OpenQuestion holds

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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.