The following is a summary of “Mortality Differences Among Myocardial Injury Subtypes in Acute COVID-19, the Omicron Wave Was Different,” published in the November 2023 issue of Cardiology by Satterfield et al.

While elevated cardiac troponin (cTn) during COVID-19 hospitalization raises mortality concerns, the specific impacts of different myocardial injury subtypes remain unclear.

Researchers conducted a retrospective study to clarify the evolving impact of distinct myocardial injury subtypes on mortality across different COVID-19 waves, from the initial surge to the milder Omicron phase.

They utilized Mayo Clinic enterprise patients to create algorithms incorporating diagnostic/procedural codes, cTn levels, and temporal relationships to positive COVID-19 PCR tests. This allowed them to identify five common subtypes of myocardial injury: stress cardiomyopathy, myocarditis, pericarditis, pulmonary embolism, and myocardial injury (MI). Analyzed hospitalized COVID-19 adults, cases identified by elevated cTn, and others as controls. Cox models included age, sex, race, ethnicity, index date, and comorbidities. The analysis focused on admission dates during Alpha-Delta or Omicron waves.

The results showed that in both wave cohorts, hospitalized patients with acute COVID-19 and myocardial injury faced an elevated mortality risk compared to those without. Patients with one of the 5 subtypes studied had a tendency for a higher risk than those in the “other myocardial injury” category. Admission during the Omicron wave, in contrast to the Alpha-Delta waves, tended to be associated with a higher mortality risk in all subtypes except myocarditis.

Investigators concluded that omicron’s milder course belied heightened mortality risk from most myocardial injury subtypes, highlighting the evolving cardiac impact of COVID-19.

Source: ahajournals.org/doi/10.1161/circ.148.suppl_1.15960