Cardiac complications in patients hospitalised with COVID-19 in Australia

Kunwardeep S. Bhatia; Hari P. Sritharan; Justin Chia; Jonathan Ciofani; Daniel Nour; Karina Chui; Sheran Vasanthakumar; Pavithra Jayadeva; Dhanvee Kandadai; Usaid Allahwala; Rohan Bhagwandeen; David B. Brieger; Christopher Y. P. Choong; Anthony Delaney; Girish Dwivedi; Benjamin Harris; Graham Hillis; Bernard Hudson; George Javorsky; Nigel Jepson; Logan Kanagaratnam; George Kotsiou; Astin Lee; Sidney T. H. Lo; Andrew I. MacIsaac; Brendan M. McQuillan; Isuru Ranasinghe; Antony Walton; James Weaver; William Wilson; Andy Yong; John Zhu; William van Gaal; Leonard Kritharides; Clara Chow; Ravinay Bhindi

doi:10.1016/j.hlc.2021.08.001

Cardiac complications in patients hospitalised with COVID-19 in Australia

Kunwardeep S. Bhatia, Hari P. Sritharan, Justin Chia, Jonathan Ciofani, Daniel Nour, Karina Chui, Sheran Vasanthakumar, Pavithra Jayadeva, Dhanvee Kandadai, Usaid Allahwala, Rohan Bhagwandeen, David B. Brieger, Christopher Y. P. Choong, Anthony Delaney, Girish Dwivedi, Benjamin Harris, Graham Hillis, Bernard Hudson, George Javorsky, Nigel JepsonLogan Kanagaratnam, George Kotsiou, Astin Lee, Sidney T. H. Lo, Andrew I. MacIsaac, Brendan M. McQuillan, Isuru Ranasinghe, Antony Walton, James Weaver, William Wilson, Andy Yong, John Zhu, William van Gaal, Leonard Kritharides, Clara Chow, Ravinay Bhindi^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

Objectives: Describe the incidence of cardiac complications in patients admitted to hospital with COVID-19 in Australia. Design: Observational cohort study. Setting: Twenty-one (21) Australian hospitals. Participants: Consecutive patients aged ≥18 years admitted to hospital with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Main outcome measures: Incidence of cardiac complications. Results: Six-hundred-and-forty-four (644) hospitalised patients (62.5±20.1 yo, 51.1% male) with COVID-19 were enrolled in the study. Overall in-hospital mortality was 14.3%. Twenty (20) (3.6%) patients developed new atrial fibrillation or flutter during admission and 9 (1.6%) patients were diagnosed with new heart failure or cardiomyopathy. Three (3) (0.5%) patients developed high grade atrioventricular (AV) block. Two (2) (0.3%) patients were clinically diagnosed with pericarditis or myopericarditis. Among the 295 (45.8%) patients with at least one troponin measurement, 99 (33.6%) had a peak troponin above the upper limit of normal (ULN). In-hospital mortality was higher in patients with raised troponin (32.3% vs 6.1%, p<0.001). New onset atrial fibrillation or flutter (6.4% vs 1.0%, p=0.001) and troponin elevation above the ULN (50.3% vs 16.4%, p<0.001) were more common in patients 65 years and older. There was no significant difference in the rate of cardiac complications between males and females. Conclusions: Among patients with COVID-19 requiring hospitalisation in Australia, troponin elevation was common but clinical cardiac sequelae were uncommon. The incidence of atrial arrhythmias and troponin elevation was greatest in patients 65 years and older.

Original language	English
Pages (from-to)	1834-1840
Number of pages	7
Journal	Heart Lung and Circulation
Volume	30
Issue number	12
DOIs	https://doi.org/10.1016/j.hlc.2021.08.001
Publication status	Published - Dec 2021
Externally published	Yes

Bibliographical note

Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

Arrhythmia
Cardiomyopathy
COVID-19
Troponin

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Bhatia, K. S., Sritharan, H. P., Chia, J., Ciofani, J., Nour, D., Chui, K., Vasanthakumar, S., Jayadeva, P., Kandadai, D., Allahwala, U., Bhagwandeen, R., Brieger, D. B., Choong, C. Y. P., Delaney, A., Dwivedi, G., Harris, B., Hillis, G., Hudson, B., Javorsky, G., ... Bhindi, R. (2021). Cardiac complications in patients hospitalised with COVID-19 in Australia. Heart Lung and Circulation, 30(12), 1834-1840. https://doi.org/10.1016/j.hlc.2021.08.001

@article{12099eab464a4cb1ab89cf18e6a55f15,

title = "Cardiac complications in patients hospitalised with COVID-19 in Australia",

abstract = "Objectives: Describe the incidence of cardiac complications in patients admitted to hospital with COVID-19 in Australia. Design: Observational cohort study. Setting: Twenty-one (21) Australian hospitals. Participants: Consecutive patients aged ≥18 years admitted to hospital with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Main outcome measures: Incidence of cardiac complications. Results: Six-hundred-and-forty-four (644) hospitalised patients (62.5±20.1 yo, 51.1% male) with COVID-19 were enrolled in the study. Overall in-hospital mortality was 14.3%. Twenty (20) (3.6%) patients developed new atrial fibrillation or flutter during admission and 9 (1.6%) patients were diagnosed with new heart failure or cardiomyopathy. Three (3) (0.5%) patients developed high grade atrioventricular (AV) block. Two (2) (0.3%) patients were clinically diagnosed with pericarditis or myopericarditis. Among the 295 (45.8%) patients with at least one troponin measurement, 99 (33.6%) had a peak troponin above the upper limit of normal (ULN). In-hospital mortality was higher in patients with raised troponin (32.3% vs 6.1%, p<0.001). New onset atrial fibrillation or flutter (6.4% vs 1.0%, p=0.001) and troponin elevation above the ULN (50.3% vs 16.4%, p<0.001) were more common in patients 65 years and older. There was no significant difference in the rate of cardiac complications between males and females. Conclusions: Among patients with COVID-19 requiring hospitalisation in Australia, troponin elevation was common but clinical cardiac sequelae were uncommon. The incidence of atrial arrhythmias and troponin elevation was greatest in patients 65 years and older.",

keywords = "Arrhythmia, Cardiomyopathy, COVID-19, Troponin",

author = "Bhatia, {Kunwardeep S.} and Sritharan, {Hari P.} and Justin Chia and Jonathan Ciofani and Daniel Nour and Karina Chui and Sheran Vasanthakumar and Pavithra Jayadeva and Dhanvee Kandadai and Usaid Allahwala and Rohan Bhagwandeen and Brieger, {David B.} and Choong, {Christopher Y. P.} and Anthony Delaney and Girish Dwivedi and Benjamin Harris and Graham Hillis and Bernard Hudson and George Javorsky and Nigel Jepson and Logan Kanagaratnam and George Kotsiou and Astin Lee and Lo, {Sidney T. H.} and MacIsaac, {Andrew I.} and McQuillan, {Brendan M.} and Isuru Ranasinghe and Antony Walton and James Weaver and William Wilson and Andy Yong and John Zhu and {van Gaal}, William and Leonard Kritharides and Clara Chow and Ravinay Bhindi",

note = "Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.",

year = "2021",

month = dec,

doi = "10.1016/j.hlc.2021.08.001",

language = "English",

volume = "30",

pages = "1834--1840",

journal = "Heart Lung and Circulation",

issn = "1443-9506",

publisher = "Elsevier",

number = "12",

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Bhatia, KS, Sritharan, HP, Chia, J, Ciofani, J, Nour, D, Chui, K, Vasanthakumar, S, Jayadeva, P, Kandadai, D, Allahwala, U, Bhagwandeen, R, Brieger, DB, Choong, CYP, Delaney, A, Dwivedi, G, Harris, B, Hillis, G, Hudson, B, Javorsky, G, Jepson, N, Kanagaratnam, L, Kotsiou, G, Lee, A, Lo, STH, MacIsaac, AI, McQuillan, BM, Ranasinghe, I, Walton, A, Weaver, J, Wilson, W, Yong, A, Zhu, J, van Gaal, W, Kritharides, L, Chow, C & Bhindi, R 2021, 'Cardiac complications in patients hospitalised with COVID-19 in Australia', Heart Lung and Circulation, vol. 30, no. 12, pp. 1834-1840. https://doi.org/10.1016/j.hlc.2021.08.001

TY - JOUR

T1 - Cardiac complications in patients hospitalised with COVID-19 in Australia

AU - Bhatia, Kunwardeep S.

AU - Sritharan, Hari P.

AU - Chia, Justin

AU - Ciofani, Jonathan

AU - Nour, Daniel

AU - Chui, Karina

AU - Vasanthakumar, Sheran

AU - Jayadeva, Pavithra

AU - Kandadai, Dhanvee

AU - Allahwala, Usaid

AU - Bhagwandeen, Rohan

AU - Brieger, David B.

AU - Choong, Christopher Y. P.

AU - Delaney, Anthony

AU - Dwivedi, Girish

AU - Harris, Benjamin

AU - Hillis, Graham

AU - Hudson, Bernard

AU - Javorsky, George

AU - Jepson, Nigel

AU - Kanagaratnam, Logan

AU - Kotsiou, George

AU - Lee, Astin

AU - Lo, Sidney T. H.

AU - MacIsaac, Andrew I.

AU - McQuillan, Brendan M.

AU - Ranasinghe, Isuru

AU - Walton, Antony

AU - Weaver, James

AU - Wilson, William

AU - Yong, Andy

AU - Zhu, John

AU - van Gaal, William

AU - Kritharides, Leonard

AU - Chow, Clara

AU - Bhindi, Ravinay

N1 - Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2021/12

Y1 - 2021/12

N2 - Objectives: Describe the incidence of cardiac complications in patients admitted to hospital with COVID-19 in Australia. Design: Observational cohort study. Setting: Twenty-one (21) Australian hospitals. Participants: Consecutive patients aged ≥18 years admitted to hospital with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Main outcome measures: Incidence of cardiac complications. Results: Six-hundred-and-forty-four (644) hospitalised patients (62.5±20.1 yo, 51.1% male) with COVID-19 were enrolled in the study. Overall in-hospital mortality was 14.3%. Twenty (20) (3.6%) patients developed new atrial fibrillation or flutter during admission and 9 (1.6%) patients were diagnosed with new heart failure or cardiomyopathy. Three (3) (0.5%) patients developed high grade atrioventricular (AV) block. Two (2) (0.3%) patients were clinically diagnosed with pericarditis or myopericarditis. Among the 295 (45.8%) patients with at least one troponin measurement, 99 (33.6%) had a peak troponin above the upper limit of normal (ULN). In-hospital mortality was higher in patients with raised troponin (32.3% vs 6.1%, p<0.001). New onset atrial fibrillation or flutter (6.4% vs 1.0%, p=0.001) and troponin elevation above the ULN (50.3% vs 16.4%, p<0.001) were more common in patients 65 years and older. There was no significant difference in the rate of cardiac complications between males and females. Conclusions: Among patients with COVID-19 requiring hospitalisation in Australia, troponin elevation was common but clinical cardiac sequelae were uncommon. The incidence of atrial arrhythmias and troponin elevation was greatest in patients 65 years and older.

AB - Objectives: Describe the incidence of cardiac complications in patients admitted to hospital with COVID-19 in Australia. Design: Observational cohort study. Setting: Twenty-one (21) Australian hospitals. Participants: Consecutive patients aged ≥18 years admitted to hospital with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Main outcome measures: Incidence of cardiac complications. Results: Six-hundred-and-forty-four (644) hospitalised patients (62.5±20.1 yo, 51.1% male) with COVID-19 were enrolled in the study. Overall in-hospital mortality was 14.3%. Twenty (20) (3.6%) patients developed new atrial fibrillation or flutter during admission and 9 (1.6%) patients were diagnosed with new heart failure or cardiomyopathy. Three (3) (0.5%) patients developed high grade atrioventricular (AV) block. Two (2) (0.3%) patients were clinically diagnosed with pericarditis or myopericarditis. Among the 295 (45.8%) patients with at least one troponin measurement, 99 (33.6%) had a peak troponin above the upper limit of normal (ULN). In-hospital mortality was higher in patients with raised troponin (32.3% vs 6.1%, p<0.001). New onset atrial fibrillation or flutter (6.4% vs 1.0%, p=0.001) and troponin elevation above the ULN (50.3% vs 16.4%, p<0.001) were more common in patients 65 years and older. There was no significant difference in the rate of cardiac complications between males and females. Conclusions: Among patients with COVID-19 requiring hospitalisation in Australia, troponin elevation was common but clinical cardiac sequelae were uncommon. The incidence of atrial arrhythmias and troponin elevation was greatest in patients 65 years and older.

KW - Arrhythmia

KW - Cardiomyopathy

KW - COVID-19

KW - Troponin

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SN - 1443-9506

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EP - 1840

JO - Heart Lung and Circulation

JF - Heart Lung and Circulation

IS - 12

ER -

Cardiac complications in patients hospitalised with COVID-19 in Australia

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