Predictors and Clinical Significance of Myocardial Injury in Elderly Patients Under the COVID-19 Pandemic

Background:The elderly patients are at increased high risk of myocardial injury and mortality after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.This study aims to investigate the prevalence, predictors and prognostic implications of myocardial injury in the elderly patients with SARS-CoV-2 infection.Methods: Patients aged over 65 years were consecutively recruited between April to May, 2022.Myocardial injury was assessed using the high-sensitivity cardiac troponin T (hs-cTnT) assay.The primary endpoint was in-hospital mortality.Results: A total of 347 patients were recruited with a median age of 81 years.45.8% were male and 18 (5.2%)deceased before discharge.Myocardial injury (hs-cTnT over 99% upper reference limit [URL]) was detected in 202 (58.2%) of patients.Predictors of myocardial injury included age (per 5-year increase), hypertension, vaccination, creatine, and neutrophil-to-lymphocyte ratio.hs-cTnT over 3 × URL was independently correlated with in-hospital mortality (adjusted odds ratio [adOR], 13.21; 95% confidence interval [CI], 2.11-87.1;p = 0.005) in comparison to hs-cTnT > URL (adOR, 0.66; 95% CI, 0.09-5.92;p = 0.680).Conclusion: Myocardial injury was a common phenomenon and prognostic predictor in elder patients after SARS-CoV-2 infection.Higher threshold of myocardial injury may be considered to improve risk stratification.