Following the publication of the above paper, it was drawn to the Editor's attention by a concerned reader that the control GAPDH western blotting data shown in Fig. 2B on p. 1385 were strikingly similar to data appearing in different form in another article written by different authors at different research institutes that had already been published in the journal Biomedicine & Pharmacotherapy. Certain of the other western blot data featured in Figs. 2 and 4 were likewise very similar to data which subsequently appeared in other articles that were unrelated to this one. In view of the fact that the abovementioned data in Fig. 2C had already apparently been published previously, the Editor of Molecular Medicine Reports has decided that this paper should be retracted from the Journal. The authors were asked for an explanation to account for these concerns, but the Editorial Office did not receive a reply. The Editor apologizes to the readership for any inconvenience caused. [Molecular Medicine Reports 22: 1382‑1390, 2020; DOI: 10.3892/mmr.2020.11188].

Background Continuous monitoring of cardiac output (CO) is limited by expensive consumables and equipment, which is rarely used in resource-limited settings. The aim of this study was to develop a novel method based on video analysis technique (called “video-based method”) to estimate CO deriving from ubiquitous smartphones. Methods Videos of minimal invasive radial arterial waveform were recorded and analyzed by a smartphone. CO values obtained from the FloTrac/Vigileo system, and video-based method were collected simultaneously. Further, we compared the performance of video-based method with commercial FloTrac/Vigileo system for clinical validation. Concordance and interchangeability of CO measurements were assessed using the intra-class correlation coefficient (ICC), mean error and the Bland-Altman analysis (B-A). Furthermore, the ability of detecting directional changes in CO values was also evaluated. Results In the clinical validation section, eleven patients who received general anesthesia were included, with a total amount of 3,892 pairs of CO values acquired. In B-A, the average CO value extracted by video-based method was 0.11 (95%CI, 0.10–0.14; p < 0.001) L/min, which was lower than that provided by the FloTrac/Vigileo system. Strong concordance (ICC = 0.87; p < 0.001) and acceptable interchangeability (mean error = 27.65%) were achieved, which indicated excellent clinical validity. Additionally, the sensitivity for significant directional changes was 92%, and the specificity was 62%. Conclusions A video-based method for cost-effective and continuous CO monitoring was successfully developed, which evaluated continuous CO values by analyzing arterial pressure waveform of recording monitor videos in real time. This video-based method provided extraordinary clinical performance, thus offering a cost-effective alternative for real-time CO monitoring.

OBJECTIVES:It is significant to know how much early detection and screening could reduce the proportion of occult metastases and benefit NSCLC patients. METHODS:We used previously designed and validated mathematical models to obtain the characteristics of LC in the population including undetectable metastases at the time of diagnosis. The survival was simulated using the survival functions from Surveillance, Epidemiology and End Results (SEER) data stratified by stage. RESULTS:Based on the simulations, 35.3% of patients diagnosed with stage N0M0 and 56.9% of those diagnosed with stage N1M0 had nodal or distant metastases that were not discovered at the time of diagnosis. Among clinically detected Stage I lung cancers with tumor diameter 1-2 cm, 78% were true stage N0M0 (no occult metastases) while it was only 37% for patients with tumor diameters of 2-3 cm. This size threshold can be translated into a 0.75-year the "window of opportunity" for the curable disease. In a comparative analysis of two simulated groups of individuals: (1) clinically diagnosed (2) diagnosed by screening with a varying screening frequency (quarterly, biannual, annual and biennial), it was estimated that, once the screening intervals become shorter, substantially more cancers are found, but at an expense of a higher radiation exposure. The simulation projected that the mortality reduction in screened patients depending on the frequency, ranged from 15.04% to 18.82%. CONCLUSIONS:The probability of occult metastases significantly increases when the primary tumor exceeds 2 cm in diameter. Effective screening measures that detect smaller tumors will considerably benefit asymptomatic LC patients.

Background: To evaluate the predictive value of sICAM-1 and sP-Selectins in the risk of death in a prospective cohort of adult acute respiratory distress syndrome (ARDS). Methods: Adult ARDS patients were included. Plasma sICAM-1, sP-Selectins, and inflammatory cytokines (TNF-α, IL-1b, IL-6, IL-8, and IL-17A) were detected in ARDS subjects. The correlation between different factors and the potential of sICAM-1 and sP-Selectins as endothelial markers to predict the risk of deathfrom ARDS was analyzed. Results: Plasma sICAM-1 and sP-Selectins were higher in ARDS patients and higher in non-survivors of ARDS. sICAM-1 was significantly correlated with TNF-α, IL-6 and IL-8, and sP-Selectins was also significantly correlated with IL-6 and IL-8. Above the critical values of 245.5 ng/mL (sICAM-1) and 482.5 ng/mL (sP-Selectins), the death of the ARDS population increased. High plasma sICAM-1 and sP-Selectins at ICU admission were independent predictors of death of ARDS patients. Conclusion: sICAM-1 and sP-Selectins can predict the risk of death in critically ill patients with ARDS.

Background: The lung ultrasound score was developed for rapidly assessing the extent of lung ventilation, and it can predict failure to wean various types of patients off mechanical ventilation. Whether it is also effective for COVID-19 patients is unclear. Methods: This single -center, prospective, observational study was conducted to assess the ability of the 12 -region lung ultrasound score to predict failure to wean COVID-19 patients off ventilation. In parallel, we assessed whether right hemidiaphragmatic excursion or previously published predictors of weaning failure can apply to these patients. Predictive ability was assessed in terms of the area under the receiver operating characteristic curve (AUC). Results: The mean age of the 35 patients in the study was (75 +/- 9) years and 12 patients (37%) could not be weaned off mechanical ventilation. The lung ultrasound score predicted these failures with an AUC of 0.885 (95% CI 0.770-0.999, p < 0.001), and a threshold score of 10 provided specificity of 72.7% and sensitivity of 92.3%. AUCs were lower for previously published predictors of weaning failure, and right hemidiaphragmatic excursion did not differ significantly between the two groups. Conclusion: The lung ultrasound score can accurately predict failure to wean critically ill COVID-19 patients off mechanical ventilation, whereas assessment of right hemidiaphragmatic excursion does not appear helpful in this regard.

Objective: The study aims to investigate the relationship between amplitude modulation (AM) of EEG and anesthesia depth during general anesthesia. Methods: In this study, Holo-Hilbert spectrum analysis (HHSA) was used to decompose the multichannel EEG signals of 15 patients to obtain the spatial distribution of AM in the brain. Subsequently, HHSA was applied to the prefrontal EEG (Fp1) obtained during general anesthesia surgery in 15 and 34 patients, and the alpha-theta and alpha-delta regions of feature (ROFs) were defined in Holo-Hilbert spectrum (HHS) and three features were derived to quantify AM in ROFs. Results: During anesthetized phase, an anteriorization of the spatial distribution of AMs of alpha-carrier in brain was observed, as well as AMs of alpha-theta and alpha-delta in the EEG of Fp1. The total power ( P-total ), mean carrier frequency ( M-FC ) and mean amplitude frequency ( MFAM ) of AMs changed during different anesthesia states. Conclusion: HHSA can effectively analyze the cross-frequency coupling of EEG during anesthesia and the AM features may be applied to anesthesia monitoring. Significance: The study provides a new perspective for the characterization of brain states during general anesthesia, which is of great significance for exploring new features of anesthesia monitoring.

Opioidergic mechanisms of repetitive transcranial magnetic stimulation (rTMS) analgesia are shaped by rTMS dose and different endogenous opioids: a randomised controlled trial. Repetitive transcranial magnetic stimulation (rTMS) is a promising technology to reduce chronic pain. Investigating the mechanisms of rTMS analgesia holds the potential to improve treatment efficacy. Using a double-blind and placebo-controlled design at both stimulation and pharmacologic ends, this study investigated the opioidergic mechanisms of rTMS analgesia by abolishing and recovering analgesia in 2 separate stages across brain regions and TMS doses. A group of 45 healthy participants were equally randomized to the primary motor cortex (M1), the dorsolateral prefrontal cortex (DLPFC), and the Sham group. In each session, participants received an intravenous infusion of naloxone or saline before the first rTMS session. Participants then received a second dose of rTMS session after the drugs were metabolized at 90 minutes. M1-rTMS-induced analgesia was abolished by naloxone compared with saline and was recovered by the second rTMS run when naloxone was metabolized. In the DLPFC, double but not the first TMS session induced significant pain reduction in the saline condition, resulting in less pain compared with the naloxone condition. In addition, TMS over the M1 or DLPFC selectively increased plasma concentrations of beta-endorphin or encephalin, respectively. Overall, we present causal evidence that opioidergic mechanisms are involved in both M1-induced and DLPFC-rTMS-induced analgesia; however, these are shaped by rTMS dosage and the release of different endogenous opioids.

BackgroundObservational studies have suggested an association between obesity and iron deficiency anemia, but such studies are susceptible to reverse causation and residual confounding. Here we used Mendelian randomization to assess whether the association might be causal.MethodsData on single-nucleotide polymorphisms that might be associated with various anthropometric indicators of obesity were extracted as instrumental variables from genome-wide association studies in the UK Biobank. Data on genetic variants in iron deficiency anemia were extracted from a genome-wide association study dataset within the Biobank. Heterogeneity in the data was assessed using inverse variance-weighted regression, Mendelian randomization Egger regression, and Cochran's Q statistic. Potential causality was assessed using inverse variance-weighted, Mendelian randomization Egger, weighted median, maximum likelihood and penalized weighted median methods. Outlier SNPs were identified using Mendelian randomization PRESSO analysis and “leave-one-out” analysis.ResultsInverse variance-weighted regression associated iron deficiency anemia with body mass index, waist circumference, trunk fat mass, body fat mass, trunk fat percentage, and body fat percentage (all odds ratios 1.003–1.004, P ≤ 0.001). Heterogeneity was minimal and no evidence of horizontal pleiotropy was found.ConclusionOur Mendelian randomization analysis suggests that obesity can cause iron deficiency anemia.

Background and Objective: Pulmonary fungal infections (PFIs) are bronchial or pulmonary diseases caused by fungi. It is necessary to explore an accurate, convenient and rapid diagnostic method for PFIs. This study was conducted to investigate the diagnostic significance of (1,3) beta-D-glucan (BDG) detection in PFI. Materials and Methods: This is a retrospective study. A total of 139 PFI patients were performed with bronchoalveolar lavage. Alveolar lavage fluid (4 mL) and fasting peripheral venous blood (2 mL) of the patients were prepared to conduct BDG detection using the ELISA method. Following this test, the patient's sputum was collected for fungal culture and the expression level of BDG in alveolar lavage fluid and blood was determined, a diagnostic value of sputum culture and BDG assay results towards PFI was explored. Results: As 126 patients were diagnosed with PFI and another 13 patients were diagnosed with bacterial infections after re-examination. Among the diagnosed patients, Aspergillus accounted for the highest proportion, 36.51%. For the diagnosed patients, the BDG expression in alveolar lavage fluid and blood specimens was sharply uplifted when compared with the undiagnosed patients (p<0.001). Among all pathogenic strains, the BDG expression reached the highest in subjects who were pathogenic to Cryptococcus (p<0.001). Conclusion: The BDG is highly efficient in diagnosing PFI. It can be used as the best clinical diagnosis target for PFI combined with a fungal culture.

Background: The outbreak of coronavirus disease 2019 (COVID-19) has become a global pandemic acute infectious disease, especially with the features of possible asymptomatic carriers and high contagious-ness. Currently, it is difficult

Hemostatic disturbances after cardiac surgery can lead to excessive postoperative bleeding. Thromboelastography (TEG) was employed to evaluate perioperative coagulative alterations in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), investigating the correlation between factors concomitant with cardiac surgery and modifications in coagulation. Coagulation index as determined by TEG correlated significantly with postoperative bleeding at 24-72 h after cardiac surgery ( P < .001). Among patients with a normal preoperative coagulation index, those with postoperative hypocoagulability showed significantly lower nadir temperature ( P = .003), larger infused fluid volume ( P = .003), and longer CPB duration ( P = .033) than those with normal coagulation index. Multivariate logistic regression showed that nadir intraoperative temperature was an independent predictor of postoperative hypocoagulability (adjusted OR: 0.772, 95% CI: 0.624-0.954, P = .017). Multivariate linear regression demonstrated linear associations of nadir intraoperative temperature ( P = .017) and infused fluid volume ( P = .005) with change in coagulation index as a result of cardiac surgery. Patients are susceptible to hypocoagulability after cardiac surgery, which can lead to increased postoperative bleeding. Ensuring appropriate temperature and fluid volume during cardiac surgery involving CPB may reduce risk of postoperative hypocoagulability and bleeding.

BACKGROUND:Patient-controlled epidural analgesia (PCEA) is well documented; however, it is unclear whether a high dosage of PCEA with a low dosage of background infusion during labor can be a safe and effective application.METHODS:Group LH was administered a continuous infusion (CI) of 0.084 mL/kg/h with PCEA of 5 mL every 40 min. Group HL was given a CI of 0.028 mL/kg/h and PCEA of 10 mL every 40 min; Group HH was given a CI of 0.084 mL/kg/h and PCEA of 10 mL every 40 min. The primary outcomes were VAS pain score, the number of supplemental boluses, incidence of pain outbreaks, drug dose for pain outbreaks, PCA times, effective PCA times, anesthetic consumption, duration of analgesia, duration of labor and delivery outcome. Secondary outcomes included adverse reactions such as itching, nausea and vomiting during analgesia and neonatal Apgar scores 1 min and 5 min after birth.RESULTS:A total of 180 patients, 60 in each group were randomly assigned to one of three groups included group LH, group HL or group HH. The VAS scores were obviously decreased in HL group and HH group in comparison with LL group at 2 h after analgesia and the time point of full cervical dilation and delivery of baby. The time for third stage of labor in HH group was increased compared with LH group and HL group. Incidence of pain outbreaks in LH group was obviously increased compared with HL and HH group. The effective PCA times in HL group and HH group were remarkably reduced compared with those in LH group.CONCLUSIONS:High dose of PCEA with a low background infusion can reduce effective PCA times, incidence of outbreak pain and the total amount of anesthetics without diminishing analgesia effects. However, high dose of PCEA with a high background infusion can enhance analgesia effect but increase the third stage of labor, instrumental delivery ratio and the total amount of anesthetics.

STUDY DESIGN:Retrospective case-control study. OBJECTIVE:To explore the association of early postoperative nadir hemoglobin with risk of a composite outcome of anemia-related and other adverse events. METHODS:We retrospectively analyzed data from spinal tumor patients who received intraoperative blood transfusion between September 1, 2013 and December 31, 2020. Uni- and multivariate logistic regression was used to explore relationships of clinicodemographic and surgical factors with risk of composite in-hospital adverse events, including death. Subgroup analysis explored the relationship between early postoperative nadir hemoglobin and composite adverse events. RESULTS:Among the 345 patients, 331 (95.9%) experienced early postoperative anemia and 69 (20%) experienced postoperative composite adverse events. Multivariate logistic regression analysis showed that postoperative nadir Hb (OR = .818, 95% CI: .672-.995, P = .044), ASA ≥3 (OR = 2.007, 95% CI: 1.086-3.707, P = .026), intraoperative RBC infusion volume (OR = 1.133, 95% CI: 1.009-1.272, P = .035), abnormal hypertension (OR = 2.199, 95% CI: 1.085-4.457, P = .029) were correlated with composite adverse events. The lumbar spinal tumor was associated with composite adverse events with a decreased odds compared to thoracic spinal tumors (OR = .444, 95% CI: .226-.876, P = .019). Compared to patients with postoperative nadir hemoglobin ≥11.0 g/dL, those with nadir <9.0 g/dL were at significantly higher risk of postoperative composite adverse events (OR = 2.709, 95% CI: 1.087-6.754, P = .032). CONCLUSION:Nadir hemoglobin <9.0 g/dL after spinal tumor surgery is associated with greater risk of postoperative composite adverse events in patients who receive intraoperative blood transfusion.

Background: The outbreak of coronavirus disease 2019 (COVID-19) has become a global pandemic acute infectious disease, especially with the features of possible asymptomatic carriers and high contagiousness. Currently, it is difficult to quickly identify asymptomatic cases or COVID-19 patients with pneumonia due to limited access to reverse transcription-polymerase chain reaction (RT-PCR) nucleic acid tests and CT scans. Goal: This study aimed to develop a scientific and rigorous clinical diagnostic tool for the rapid prediction of COVID-19 cases based on a COVID-19 clinical case database in China, and to assist doctors to efficiently and precisely diagnose asymptomatic COVID-19 patients and cases who had a false-negative RT-PCR test result. Methods: With online consent, and the approval of the ethics committee of Zhongshan Hospital Fudan University (NCT04275947, B2020-032R) to ensure that patient privacy is protected, clinical information has been uploaded in real-time through the New Coronavirus Intelligent Auto-diagnostic Assistant Application of cloud plus terminal (nCapp) by doctors from different cities (Wuhan, Shanghai, Harbin, Dalian, Wuxi, Qingdao, Rizhao, and Bengbu) during the COVID-19 outbreak in China. By quality control and data anonymization on the platform, a total of 3,249 cases from COVID-19 high-risk groups were collected. The effects of different diagnostic factors were ranked based on the results from a single factor analysis, with 0.05 as the significance level for factor inclusion and 0.1 as the significance level for factor exclusion. Independent variables were selected by the step-forward multivariate logistic regression analysis to obtain the probability model. Findings: We applied the statistical method of a multivariate regression model to the training dataset (1,624 cases) and developed a prediction model for COVID-19 with 9 clinical indicators that are accessible. The area under the receiver operating characteristic (ROC) curve (AUC) for the model was 0.88 (95% CI: 0.86, 0.89) in the training dataset and 0.84 (95% CI: 0.82, 0.86) in the validation dataset (1,625 cases). Discussion: With the assistance of nCapp, a mobile-based diagnostic tool developed from a large database that we collected from COVID-19 high-risk groups in China, frontline doctors can rapidly identify asymptomatic patients and avoid misdiagnoses of cases with false-negative RT-PCR results.

目的 探讨叉头框转录因子（FOX）M1在小细胞肺癌（SCLC）细胞对顺铂耐药中的作用及机制。方法 采用浓度梯度法建立对顺铂耐药的人SCLC H446细胞系（H446/DDP）,采用荧光定量聚合酶链反应（qRT-PCR）和蛋白质免疫印迹法（Western blot）检测其FOXM1基因mRNA及蛋白表达水平。构建FOXM1基因真核过表达载体转染H446细胞，检测转染不同载体H446细胞FOXM1基因mRNA和蛋白表达水平及转染不同载体H446/DDP的细胞存活率并进行比较。设计靶向FOXM1的小干扰RNA（siRNA）,采用Interferin和FOXM1 siRNA（H446-siFOXM1组、H446/DDP-siFOXM1组）或阴性对照RNA（H446-NC组、H446/DDP-NC组）转染细胞，比较各组细胞的存活率及FOXM1下游基因CDC25B、survivin和cyclin B1 mRNA表达水平。结果 H446/DDP细胞FOXM1基因mRNA、蛋白表达水平均高于H446细胞（P＜0.01）。FOXM1过表达载体转染H446细胞FOXM1基因mRNA和蛋白表达水平均高于转染空白载体H446细胞（P＜0.01）。FOXM1过表达载体转染H446/DDP细胞存活率低于转染空白载体H446/DDP细胞（P＜0.01）。H446-siFOXM1组FOXM1基因mRNA和蛋白表达水平均低于H446-NC组，细胞存活率高于H446-NC组（P＜0.01）;H446/DDP-siFOXM1组FOXM1基因mRNA和蛋白表达水平均低于H446/DDP-NC组，细胞存活率高于H446/DDP-NC组（P＜0.01）。H446/DDP-NC组CDC25B、survivin和cyclin B1 mRNA表达水平均高于H446-NC组（P＜0.01）;H446/DDP-siFOXM1组CDC25B、survivin和cyclin B1 mRNA表达水平均高于H446-siFOXM1组（P＜0.01）。结论 FOXM1基因的异常表达可能通过调控CDC25B、survivin和cyclin B1的表达促进SCLC细胞对顺铂耐药。

Background: In March 2020, the World Health Organization (WHO) declared COVID-19 a public health emergency of international concern. A small proportion of patients infected with COVID-19 go on to develop pneumonia. We speculated that COVID-19 may be likely to result in psychological disorders such as anxiety and depression. In this study, we conducted an investigation of anxiety and depression in patients with COVID-19. Methods: Sixty-five COVID-19 patients were randomly enrolled into this study. Anxiety and depression among participants were measured through the completion of anonymous Chinese-language Zung self-rating anxiety scale and self-rating depression scale questionnaires. Data were analyzed using independent samples t-tests, Mann-Whitney U-tests, and χ2 tests. Results: The questionnaire results showed that 26.15% and 41.54% of participants suffered from anxiety and depression, respectively, although there was no significantly statistical difference between the proportions of COVID-19 patients with anxiety and depression. Statistically significant differences in employment status, partial pressure of oxygen, and corticosteroid application existed between moderate- and severe COVID-19 patients (P<0.05). In particular, the partial pressure of oxygen was significantly lower in severe COVID-19 patients than in their moderate counter parts (71.31±23.54 vs. 101.06±34.43, U=156, P=0.006). Total lymphocytes was lower in severe group than in moderate group [1.659±0.643 vs. 0.745 (0.645, 0.928), U=109, P=0.000]. Also, a higher proportion of female than male patients had anxiety (χ2=5.388, P=0.02). COVID-19 patients who received antiviral medications also displayed a higher rate of anxiety (χ2=4.481, P=0.034). Total lymphocytes between the non-anxiety and anxiety had statistical difference (U=321, P=0.019). Meanwhile, total lymphocytes between the non-depression and depression also had statistical difference (U=389.5, P=0.01). Conclusions: Among patients with COVID-19, females and those treated with antiviral medications were more likely to experience anxiety. In addition, our findings reflected the effect of anxiety and depression on immune system.

Chaomin Wu, MD; Xiaoyan Chen, MD; Yanping Cai, MD; Jia'an Xia, MD; Xing Zhou, MD; Sha Xu, MD; Hanping Huang, MD; Li Zhang, MD; Xia Zhou, MD; Chunling Du, MD; Yuye Zhang, BD; Juan Song, BD; Sijiao Wang, BD; Yencheng Chao, MD; Zeyong Yang, MD; Jie Xu, MD; Xin Zhou, MD; Dechang Chen, MD; Weining Xiong, MD; Lei Xu, MD; Feng Zhou, MD; Jinjun Jiang, MD; Chunxue Bai, MD; Junhua Zheng, MD; Yuanlin Song, MD

AbstractImportanceHeart injury can be easily induced by viral infection such as adenovirus and enterovirus. However, whether coronavirus disease 2019 (COVID-19) causes heart injury and hereby impacts mortality has not yet been fully evaluated.ObjectiveTo explore whether heart injury occurs in COVID-19 on admission and hereby aggravates mortality later.Design, Setting, and ParticipantsA single-center retrospective cohort study including 188 COVID-19 patients admitted from December 25, 2019 to January 27, 2020 in Wuhan Jinyintan Hospital, China; follow up was completed on February 11, 2020.ExposuresHigh levels of heart injury indicators on admission (hs-TNI; CK; CK-MB; LDH; α-HBDH).Main Outcomes and MeasuresMortality in hospital and days from admission to mortality (survival days).ResultsOf 188 patients with COVID-19, the mean age was 51.9 years (standard deviation: 14.26; range: 21∼83 years) and 119 (63.3%) were male. Increased hs-TnI levels on admission tended to occur in older patients and patients with comorbidity (especially hypertension). High hs-TnI on admission (≥ 6.126 pg/mL), even within the clinical normal range (0∼28 pg/mL), already can be associated with higher mortality. High hs-TnI was associated with increased inflammatory levels (neutrophils, IL-6, CRP, and PCT) and decreased immune levels (lymphocytes, monocytes, and CD4+ and CD8+ T cells). CK was not associated with mortality. Increased CK-MB levels tended to occur in male patients and patients with current smoking. High CK-MB on admission was associated with higher mortality. High CK-MB was associated with increased inflammatory levels and decreased lymphocytes. Increased LDH and α-HBDH levels tended to occur in older patients and patients with hypertension. Both high LDH and α-HBDH on admission were associated with higher mortality. Both high LDH and α-HBDH were associated with increased inflammatory levels and decreased immune levels. hs-TNI level on admission was negatively correlated with survival days (r= -0.42, 95% CI= -0.64∼-0.12, P=0.005). LDH level on admission was negatively correlated with survival days (r= -0.35, 95% CI= -0.59∼-0.05, P=0.022).Conclusions and RelevanceHeart injury signs arise in COVID-19, especially in older patients, patients with hypertension and male patients with current smoking. COVID-19 virus might attack heart via inducing inflammatory storm. High levels of heart injury indicators on admission are associated with higher mortality and shorter survival days. COVID-19 patients with signs of heart injury on admission must be early identified and carefully managed by cardiologists, because COVID-19 is never just confined to respiratory injury.Key pointsQuestionDoes coronavirus disease 2019 (COVID-19) cause heart injury and hereby impact mortality?FindingsIn this retrospective cohort study including 188 patients with COVID-19, patients with high levels of high-sensitivity cardiac troponin I (hs-TNI) on admission had significantly higher mortality (50.0%) than patients with moderate or low levels of hs-TNI (10.0% or 9.1%). hs-TNI level on admission was significantly negatively correlated with survival days (r= -0.42, 95% CI= -0.64∼-0.12, P=0.005).MeaningCOVID-19 patients with signs of heart injury on admission must be early identified and carefully managed by cardiologists, in order to maximally prevent or rescue heart injury-related mortality in COVID-19.