Patients with SARS-CoV-2 Omicron variant infection complicated with myocardial injury: a retrospective cohort study

INTRODUCTION: The SARS-CoV-2 virus and its variants affect not only the respiratory system but also the heart. The impact of SARS-CoV-2 on the heart during the Omicron pandemic is not yet fully elucidated. METHODOLOGY: We conducted a retrospective cohort study of 1,026 hospitalized patients with the Omicron variant at Southwest Hospital (December 2022 to March 2023). Adverse events were defined as a composite of all-cause mortality, intensive care unit admission, mechanical ventilation use, and discharge against medical advice. The risk factors were analyzed by Logistic regression and the Cox regression model. RESULTS: Median age was 69 years (IQR 56-79), myocardial injury occurred in 54.7% (n = 561); adverse events occurred in 25.5% (n = 262). The risk factors of myocardial injury included older age (OR 1.04 [1.03, 1.05], p < 0.001), body temperature at admission (OR 1.64 [1.19, 2.29], p = 0.003), critical COVID-19 (OR 4.96 [2.34, 11.54], p < 0.001), severe valvular heart disease (OR 2.46 [1.06, 6.12], p = 0.042), renal insufficiency (OR 4.04 [2.75, 6.01], p < 0.001), anemia (OR 3.10 [2.12, 4.58], p < 0.001), type II respiratory failure (OR 5.54 [1.79, 24.39], p = 0.008) and higher white blood cell (OR 1.09 [1.05, 1.14], p < 0.001). After adjustment, myocardial injury (HR 1.79 [1.28, 2.48], p = 0.001) was significantly associated with adverse events in patients with Omicron variant infection. CONCLUSIONS: Myocardial injury, the most common extrapulmonary complication of COVID-19 caused by the SARS-CoV-2 Omicron variant, requires timely attention to prevent adverse events in hospitalized patients.