Clinical Characteristics and Risk Factors of Cardiac Involvement in COVID-19.
Clinical Characteristics and Risk Factors of Cardiac Involvement in COVID-19.
复制标题
COVID-19 心脏受累的临床特征和危险因素
DOI：
10.1161/jaha.120.016807
复制
发表时间：
2020-09-15
影响因子：
5.4
通讯作者：
Guo Y
中科院分区：
文献类型：
--
作者：
Xu H;Hou K;Xu R;Li Z;Fu H;Wen L;Xie L;Liu H;Selvanayagam JB;Zhang N;Yang Z;Yang M;Guo Y
越来越多的研究表明，心脏受累与2019冠状病毒病（COVID-19）有关。因此，我们调查了COVID-19患者的临床特征，并进一步确定了心脏受累的风险因素。我们分析了102名连续实验室确诊和住院的COVID-19患者（52名年龄在19-87岁之间的女性）的数据。收集流行病学和人口统计学特征、临床特征、常规实验室检查（包括心脏损伤生物标志物）、超声心动图、心电图、胸部影像学检查结果、管理方法和临床结局。根据心肌标志物水平的不同将患者分为急性心肌损伤组、心肌标志物异常组和无心肌标志物异常组。在这项研究中，102例患者中有72例（70.6%）发现心脏受累：心动过速（n=20）、心电图异常（n=23）、超声心动图异常（n=59）、心肌酶升高（n=55）和急性心脏损伤（n=9）。8例急性心脏损伤患者年龄>60岁;其中7例有≥2种基础合并症（高血压、糖尿病、心血管疾病、慢性阻塞性肺疾病和慢性肾脏疾病）。合并急性心脏损伤的患者中，新型冠状病毒肺炎的严重程度明显高于未确诊的急性心脏损伤患者（P<0.001）。多变量分析显示，CRP（C反应蛋白）水平、高龄、新型冠状病毒肺炎严重程度和基础合并症是COVID-19患者心脏异常的风险因素。心脏受累在COVID-19患者中很常见。CRP水平升高、高龄、基础合并症和新型冠状病毒肺炎严重程度是COVID-19患者心脏受累的主要风险因素。在COVID-19治疗期间，应更多关注心血管保护，以降低死亡率。URL：https://www.chictr.org;唯一标识符：ChiCTR 2000029955。
Increasing studies demonstrated that the cardiac involvements are related to coronavirus disease 2019 (COVID‐19). Thus, we investigated the clinical characteristics of patients with COVID‐19 and further determined the risk factors for cardiac involvement in them. We analyzed data from 102 consecutive laboratory‐confirmed and hospitalized patients with COVID‐19 (52 women aged 19–87 years). Epidemiologic and demographic characteristics, clinical features, routine laboratory tests (including cardiac injury biomarkers), echocardiography, electrocardiography, chest imaging findings, management methods, and clinical outcomes were collected. Patients were divided into acute cardiac injury, with and without cardiac marker abnormities groups according to different level of cardiac markers. In this research, cardiac involvement was found in 72 of the 102 (70.6%) patients: tachycardia (n=20), electrocardiography abnormalities (n=23), echocardiography abnormalities (n=59), elevated myocardial enzymes (n=55), and acute cardiac injury (n=9). Eight patients with acute cardiac injury were aged >60 years; seven of them had ≥2 underlying comorbidities (hypertension, diabetes mellitus, cardiovascular diseases, chronic obstructive pulmonary disease, and chronic kidney disease). Novel coronavirus pneumonia was much more severe in the patients with acute cardiac injury than in patients with nondefinite acute cardiac injury (P<0.001). Multivariate analyses showed that CRP (C‐reactive protein) levels, old age, novel coronavirus pneumonia severity, and underlying comorbidities were the risk factors for cardiac abnormalities in patients with COVID‐19. Cardiac involvements are common in patients with COVID‐19. Elevated CRP levels, old age, underlying comorbidities, and novel coronavirus pneumonia severity are the main risk factors for cardiac involvement in patients with COVID‐19. More attention should be given to cardiovascular protection during COVID‐19 treatment for mortality reduction. URL: https://www.chictr.org; Unique identifier: ChiCTR2000029955.