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Heartbeat: Heart disease and COVID-19
  1. Catherine M Otto
  1. Division of Cardiology, University of Washington, Seattle, WA 98115, USA
  1. Correspondence to Professor Catherine M Otto, Division of Cardiology, University of Washington, Seattle, WA 98115, USA; cmotto{at}

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During the COVID-19 pandemic it has become evident that the interaction between COVID-19 infection and cardiovascular disease goes both ways: patients with underlying cardiovascular disease (CVD) are at higher risk of adverse outcomes if infected; conversely, regardless of the presence of absence of underlying cardiovascular disease, acute myocardial injury is common in patients with COVID-19 infection. In this issue of Heart Wei and colleagues1 report that in a prospective study of 101 cases of COVID-19 in Sichuan, China, acute myocardial injury was present in 15.8% of patients, with an elevation in high-sensitivity troponin T (hs-TnT) more than five times normal in many patients. Clinical factors associated with an elevated hs-TnT were older age and pre-existing CVD. An elevated hs-TnT level was associated with a higher likelihood of mortality, admission to the intensive care unit, mechanical ventilation, and treatment with vasoactive agents. (table 1)

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Table 1

In-hospital clinical outcomes in 101 cases of COVID-19 in Sichuan, China

In the accompanying editorial, Cheng and Leedy2 discuss the likely pathophysiology of myocardial injury in patient with COVID-19 infection including unmasking of underlying cardiovascular disease, coronary plaque rupture and cytokine release syndrome. They also emphasise the importance of identifying the underlying …

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