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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 32, No 2, March/April 2021
82
AFRICA
Hypertension was the lead chronic medical illness, with a
rate of 39% of the total patients that had COVID-19. Diabetes
was second, with a rate of 22% of all patients. Chronic kidney
disease, coronary artery disease, chronic obstructive pulmonary
disease and chronic heart failure were the other most common
diseases, respectively. The incidences of all chronic diseases
were statistically different in patients with and without cardiac
injury (Table 1). However, there was no statistically significant
difference in angiotensin converting enzyme inhibitor (ACEI) or
angiotensin receptor blocker (ARB) usage in patients with and
without cardiac injury (Table 1).
Baseline laboratory findings, blood gas analysis and chest CT
of the patients with and without cardiac injury are shown in Table
2. Serum creatinine, gamma-glutamyl transferase (GGT), alkaline
phosphatase (ALP), LDH, CRP, ferritin, D-dimer, hs-TNT,
NT-proBNP and fibrinogen levels were statistically significantly
different in patients with and without cardiac injury (Table 2).
The appearance of severe pneumonia (multiple mottling
and ground-glass opacity) in thorax CT scans was statistically
significantly higher in patients with cardiac injury than in those
without (
p
<
0.01) (Table 2). In addition, mortality, hospital
discharge and ICU admission rates were statistically significantly
higher in patients with cardiac injury than in those without
(Table 2).
Cardiovascular outcomes of hospitalised patients were acute
myocardial injury, with a rate of 25% (78 patients), acute coronary
syndrome, with a rate of 0.6% (two patients), myocarditis, with
a rate of 0.6% (two patients), arterial thrombosis, with a rate
of 0.3% (one patient), venous thrombosis, with a rate of 0.9%
(three patients), stroke, with a rate of 0.3% (one patient), and
malignant ventricular arrhythmia, with a rate of 0.3% (one
patient) (Table 3).
Correlations between hs-TNT, inflammatory markers and
NT-proBNP are shown in Table 4. There was a strong correlation
Table 2. Baseline laboratory findings, blood gas analysis and chest computed tomography of the patients
Patients, n (%)
Variables
Cardiac injury
p-value
Laboratory findings, median (range)
All (n
=
309)
With (n
=
78)
Without (n
=
231)
WBC, cells/
μ
l
7284 (280–97110)
9175 (280–97110)
6643 (1470–58330)
0.005
Lymphocytes, cells/
μ
l
1384 (110–81150)
1927 (110–81150)
1200 (350–2800)
>
0.05
Platelets, ×10
3
cells/
μ
l
216 (10.5–552)
223 (10.5–518)
213 (42.5–552)
>
0.05
Haemoglobin, g/dl
13 (6.1–17.7)
12 (6.1–16.1)
13.4 (6.2–17.7)
<
0.001
ALT, U/l
31 (4–508)
33 (7–508)
31 (4–170)
>
0.05
AST, U/l
36 (9.8–302)
42 (10–362)
34 (12–159)
>
0.05
Albumin, g/dl
3.9 (1.9–5.1)
3.6 (1.9–4.7)
4 (2.1–5.1)
>
0.05
Creatinine, mg/dl
1.09 (0.4–18)
1.6 (0.6–18)
0.92 (0.4–2.5)
<
0.001
Potassium, mEq/l
4.2 (2.9–6)
4.3 (3–6)
4.2 (2.9–5.7)
>
0.05
Sodium, mEq/l
137 (124–151)
136 (124–151)
137 (128–147)
>
0.05
Glucose, mg/dl
134 (73–633)
149 (75–633)
129 (73–399)
>
0.05
GGT, U/l
48 (5–718)
65 (6–718)
42 (5–711)
0.02
ALP, U/l
74 (28–381)
93 (38–381)
68 (28–266)
<
0.001
LDH, U/l
14 (131–1135)
353 (136–1135)
280 (131–706)
<
0.001
C-reactive protein, mg/l
73 (1–460)
113 (1–460)
60 (1–359)
<
0.001
Procalcitonin, ng/ml
0.6 (0–57)
1.2 (0–57)
0.4 (0–48)
>
0.05
Ferritin, ng/ml
603 (14–5812)
790 (21–5083)
537 (14–5812)
0.01
D-dimer,
μ
g/l
1310 (230–19440)
2157 (270–10850)
1022 (230–19440)
<
0.001
hs-TNT, pg/ml
38 (3–3417)
137 (14–3417)
5 (3–13)
<
0.001
NT Pro-BNP, pg/ml
714 (5–35000)
2522 (17–35000)
120 (5–2977)
<
0.001
Fibrinogen, mg/dl
549 (146–1028)
588 (146–1028)
535 (278–792)
0.004
aPTT, s
30 (14–65)
32 (22–65)
29 (14–58)
>
0.05
Blood gas analysis
PaO
2
, mmHg
62 (36–132)
60.5 (36–132)
62.8 (36–102)
>
0.05
PaCO
2
, mmHg
40 (22–66)
37.2 (23–66)
41.7 (22–60)
>
0.05
Lactic acid, mmol/l
1.7 (0.7–6.2)
1.8 (0.8–6.2)
1.7 (0.7–4.1)
>
0.05
HCO
3
, mEq/l
24 (10–33)
22.7 (10–33)
25 (17–33)
>
0.05
Chest radiography and CT findings
Pneumonia
Mild (unilateral)
158 (51)
31 (40)
127 (55)
>
0.05
Moderate (bilateral)
84 (27)
19 (24)
65 (28)
>
0.05
Severe (multiple mottling and ground-glass opacity)
67 (22)
28 (36)
39 (17)
<
0.01
Clinical outcomes
Mortality
10 (3)
6 (7.7)
4 (1.7)
0.01
Discharge
160 (52)
22 (28)
138 (60)
<
0.001
Hospital duration (days)
8 (2–20)
8 (4–20)
7 (2–11)
>
0.05
ICU admission
32 (10)
19 (24)
13 (6)
<
0.001
WBC, white blood cells; ALT, alanine aminotransferase; AST, aspartate aminotransferase; GGT, gamma-glutamyl transferase; ALP, alkaline phosphatase; LDH,
lactate dehydrogenase; hs-TNT, high-sensitivity troponin T; NT-proBNP, N-terminal proB-type natriuretic peptide; aPTT, activated partial thromboplastin time; CT,
computed tomography; ICU; intensive care unit.