THE OCCURRENCE AND MORTALITY ASSOCIATED WITH MYOCARDIAL ISCHEMIA AND INJURY IN SARS-COV-2 INDUCED SEPSIS: A RETROSPECTIVE MULTICENTER OBSERVATIONAL ANALYSIS

Background: Acute non-ST segment elevation myocardial infarction (NSTEMI) has been seen as a complication in patients with SARS-CoV-2 infection, however, it remains unclear whether this injury results from acute coronary syndrome with direct myocardial injury (ACS-MI) versus demand ischemia (DI), the pattern of MI related to varied activation of inflammatory responses and supply-demand imbalance. Further investigation using serial electrocardiography (ECG) is needed for a thorough cardiac evaluation, as isolated changes in cardiac troponin (cTn) are not always diagnostic of intrinsic myocardial ischemia and injury. Methods: A retrospective chart review of baseline characteristics, highest cTn and admission ECG from SARS-CoV-2 positive patients admitted across ten different medical centers within the United States between March 1 to May 31, 2020 were obtained using electronic medical records. The primary endpoint was the identification of incidence of DI in SARS-CoV-2 viral sepsis. The secondary endpoints compared mortality. Results: 865 patients hospitalized with SARS-CoV-2 were included in this study, with 49.60% males and 50.40% females, mean age 60 ± 17 years. Out of 221 patients with diagnosed SARS-CoV-2 viral sepsis, 15.84% (35 patients) had DI, whereas 3.62% (8 patients) had ACS-MI. In the 164 SARS-CoV-2 patients with elevated cTn, 26.22% had ACS-MI, with showing of variant] comparisons with ACS-MI. Further analysis with strict echocardiography and angiographic data will in further the nature and extent of myocardial ischemia/infarction and hence the prognosis of NSTEMI in patients with SARS-CoV-2.