32 / 60
CARDIOVASCULAR JOURNAL OF AFRICA • Volume 32, No 2, March/April 2021
86
AFRICA
to the limiting conditions in the COVID isolation wards. Second,
the cause of death may have included multiple organ dysfunction
in most cases, and it was difficult to identify myocardial injury
as the main and direct cause in individual cases. Long-term
observations and prospective studies are needed.
Conclusion
The first general data of our 309 COVID-19 patients regarding
low mortality and ICU admision rates, and detailed treatment
algorithms specific to our centre should be helpful in determining
better treatment strategies in the future. Our study emphasises
the importance and frequency of cardiovascular outcomes,
and the importance of certain cardiac biomarkers in predicting
COVID-19 prognosis.
References
1.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J,
et al.
Clinical characteristics
of 138 hospitalized patients with 2019 novel coronavirus-infected pneumo-
nia in Wuhan, China.
J Am Med Assoc
2020 Feb 7. [Epub ahead of print].
2.
Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W,
et al
. A pneu-
monia outbreak associated with a new coronavirus of probable bat
origin.
Nature
2020;
579
: 270–273.
3.
Naming the coronavirus disease (COVID-19) and the virus that causes
it. [cited 2020 Mar 21]. Available at:
https://www.who. int/emergen-
cies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-
coronavirus-disease-(covid-2019)-and-the-virusthat-causes-it. Accessed
Mar 23, 2020.
4.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y,
et al
. Clinical features of
patients infected with 2019 novel coronavirus in Wuhan, China.
Lancet
2020;
395
: 497–506.
5.
Zeng J, Huang J, Pan L. How to balance acute myocardial infarc-
tion and COVID 19: the protocols from Sichuan Provincial People’s
Hospital.
Intensive Care Med
2020 Mar 11. [Epub ahead of print].
6.
Li B, Yang J, Zhao F, Zhi L, Wang X, Liu L,
et al
. Prevalence and impact
of cardiovascular metabolic diseases on COVID-19 in China.
Clin Res
Cardiol
2020 Mar 11. [Epub ahead of print].
7.
Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Bondi-Zoccai
G,
et al.
Cardiovascular considerations for patients, health care workers,
and health systems during the coronavirus disease 2019 (COVID-19)
pandemic.
J Am Coll Cardiol
2020;
75
(18): 2352–2371.
8.
World Health Organization. Clinical management of severe acute respir-
atory infection when novel coronavirus (nCoV) infection is suspected:
interim guidance. Published January 28, 2020. Accessed January 31,
2020. https://www. who.int/publications-detail/clinical-managementof-
severe-acute-respiratory-infection-when-novelcoronavirus-(ncov)-infec-
tion-is-suspected.
9.
Huang C, Wang Y, Li X,
et al.
Clinical features of patients infected
with 2019 novel coronavirus in Wuhan, China.
Lancet
2020;
395
(10223):
497–506.
10. Shi S, Qin M, Shen B,
et al.
Association of cardiac injury with mortality
in hospitalized patients with COVID-19 in Wuhan, China.
J Am Med
Assoc Cardiol
2020. [Published online March 25, 2020].
11. Guan WJ, Ni ZY, Hu Y,
et al.
Clinical characteristics of 2019 novel coro-
navirus infection in China.
N Engl J Med
2020. https:// www.medrxiv.
org/content/10.1101/2020.02.06. 20020974v1.
12. Oudit GY, Kassiri Z, Jiang C,
et al
. SARS-coronavirus modulation
ofmyocardial ACE2 expression and inflammation in patients with
SARS.
Eur J Clin Invest
2009;
39
(7): 618–625.
13. Zhu N, Zhang D, Wang W,
et al
., China novel coronavirus investigating
and research team. A novel coronavirus from patients with pneumonia
in China, 2019.
N Engl J Med
2020;
382
(8): 727–733.
14. Xu X, Chen P,Wang J,
et al
. Evolution of the novel coronavirus from the
ongoing Wuhan outbreak and modeling of its spike protein for risk of
human transmission.
Sci China Life Sci
2020;
63
(3): 457–460.
15. Guo T, Fan Y, Chen M,
et al
. Cardiovascular implications of fatal
outcomes of patients with coronavirus disease 2019 (COVID-19).
J Am
Med Assoc Cardiol
2020: e201017.
16. Lippi G, Henry BM. Active smoking is not associated with severity
of coronavirus disease 2019 (COVID-19).
Eur J Intern Med
2020;
75
:
107 – 108.
70.00
60.00
50.00
40.00
30.00
20.00
10.00
1.00 2.00 3.00
Thorax CT
Mean of hs-TNT, pg/ml
1400.00
1 200.00
1 000.00
800.00
600.00
400.00
1.00 2.00 3.00
Thorax CT
Mean of NT-proBNP, pg/ml
Thorax CT: 1 (mild pneumonia), 2 (moderate pneumonia), 3 (severe pneumonia)
Fig. 5.
Mean plots of serum levels of high-sensitivity troponin T and NT-proBNP compared with patients grouped according to thorax
CT scans, which were divided into three categories: 1, mild pneumonia; 2, moderate pneumonia; and 3, severe pneumonia.