Cardiovascular disease potentially contributes to the progression and poor prognosis of COVID-19
Cardiovascular disease potentially contributes to the progression and poor prognosis of COVID-19
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心血管疾病可能导致 COVID-19 的进展和不良预后
DOI：
10.1016/j.numecd.2020.04.013
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发表时间：
2020-06-25
影响因子：
3.9
通讯作者：
Hu, Desheng
中科院分区：
文献类型：
--
作者：
Li, Mingyue;Dong, Yalan;Hu, Desheng
背景和目的：一种新型冠状病毒严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)引起的肺炎--冠状病毒病2019(新冠肺炎)于2019年12月在武汉、中国暴发，并在全球范围内传播。新冠肺炎患者在住院时间、病情进展和预后方面存在巨大差异。据报道，这些合并症可能在新冠肺炎中扮演重要角色。方法与结果：将确诊的83例新冠肺炎患者按病史分为心血管疾病组(n=42)和非心血管疾病组(n=41)。收集、分析、比较两组的人口学资料、病史、临床特征、实验室检查、胸部CT及治疗措施。新冠肺炎脑血管病患者表现为(1)肺组织病理改变加重，(2)损伤相关酶α-羟丁酸脱氢酶(HDBH)、乳酸脱氢酶(LDH)、丙氨酸氨基转移酶(GGT)、肌酸激酶(CK)、丙氨酸氨基转移酶(ALT)升高，(3)C反应蛋白(CRP)、白细胞介素6(IL-6)、血清铁蛋白、血沉、血清淀粉样蛋白A(SAA)等炎症相关指标明显升高，反映严重高凝状态。病死率高于无心血管疾病的新冠肺炎患者。结论：心血管疾病是新冠肺炎病情进展快、预后差的重要危险因素。对心脑血管疾病患者应给予更严密的医疗护理，以防止病情迅速恶化。(C)2020年意大利糖尿病学会、意大利动脉粥样硬化研究学会、意大利人类营养学会和费德里科二世大学临床内外科。爱思唯尔出版公司(Elsevier B.V.)
Background and aim: A novel coronavirus severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) caused pneumonia, Coronavirus Disease 2019 (COVID-19), broke out in Wuhan, China in December 2019, and spread all over the world. Patients with COVID-19 showed huge differences in the hospital stay, progression, and prognosis. As reported, the comorbidities may play an important role in COVID-19. Here, we aim to address the role of cardiovascular disease (CVD) in the progression and prognosis of COVID-19.Methods and results: Eighty-three confirmed COVID-19 patients were divided into CVD (n = 42) and non-CVD (n = 41) group according to their medical history. Medical records including demographic data, medical history, clinical characteristics, laboratory examinations, chest computed tomography (CT), and treatment measures were collected, analyzed, and compared between the two groups. COVID-19 patients with CVD showed (1) more severe pathological changes in the lungs, (2) elevated injury-related enzymes including alpha-hydroxybutyrate dehydrogenase (HDBH), lactic dehydrogenase (LDH), gamma-glutamyltransferase (GGT), creatine kinase (CK), and alanine aminotransferase (ALT), (3) significantly increased uncontrolled inflammation related markers, such as c-reactive protein (CRP), interleukin (IL)-6, serum ferritin, erythrocyte sedimentation rate (ESR), and serum amyloid A (SAA), (4) serious hypercoagulable status reflected by increased D-dimer and serum fibrinogen (FIB), and (5) higher mortality, compared to COVID-19 patients without CVD.Conclusions: Our data indicated that CVD is a strong risk factor for rapid progression and bad prognosis of COVID-19. More intensive medical care should be applied to patients with CVD to prevent rapid deterioration of the disease. (C) 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V.