Hemodynamic changes in patients with SARS-CoV-2 infection presenting for cesarean delivery under spinal anesthesia: a retrospective case-control study.
Hemodynamic changes in patients with SARS-CoV-2 infection presenting for cesarean delivery under spinal anesthesia: a retrospective case-control study.
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DOI：
10.1016/j.ijoa.2022.103624
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发表时间：
2023-02
影响因子：
2.8
通讯作者：
Kovacheva, V. P.
中科院分区：
文献类型：
--
作者：
Scoon, L. E. G.;Gray, K. J.;Zhou, G.;Cohen, R. Y.;Armero, W.;Chen, Y. K.;Ray, A. M.;Diouf, K.;Goldfarb, I. T.;Boatin, A. A.;Kovacheva, V. P.
2019冠状病毒病（COVID-19）与孕产妇和新生儿的不良结局有关。早期研究表明，COVID-19与产妇在轴向麻醉后低血压的发生率较高有关。我们采用回顾性病例-对照设计，探讨脊髓麻醉对严重呼吸窘迫综合征-冠状病毒2 （SARS-CoV-2）阳性孕妇剖宫产的血液动力学反应。我们检索了剖宫产脊髓麻醉、SARS-CoV-2阳性或分娩时恢复的患者的电子病历，并使用了两家三级医院的历史和SARS-CoV-2阴性对照。我们比较了分娩时SARS-CoV-2阳性患者、妊娠期间阳性并在分娩前康复的患者和对照组之间的人口统计学、临床和血流动力学变量。根据患者分娩时的正常和高血压状态进行分层分析。我们发现22例SARS-CoV-2阳性，73例SARS-CoV-2康复，1517例对照。经协变量调整后，SARS-CoV-2阳性和恢复的孕妇平均分别为5.6和2.2 mmHg，脊髓后平均动脉压（MAPs）高于对照组。此外，脊髓后最低MAP与高血压患者出现COVID-19症状和分娩之间的天数呈负相关（相关性- 0.55,95% CI - 0.81至- 0.09）。妊娠期感染SARS-CoV-2的患者比未感染的患者表现出更少的脊柱低血压。虽然这一发现的临床意义尚不清楚，但它指出了该病毒对心血管的重要影响。
Coronavirus disease 2019 (COVID-19) is associated with adverse maternal and neonatal outcomes. Early studies suggested that COVID-19 was associated with a higher incidence of hypotension following neuraxial anesthesia in parturients. We explored the hemodynamic response to spinal anesthesia for cesarean delivery in pregnant severe respiratory distress syndrome-coronavirus-2 (SARS-CoV-2) positive patients, using a retrospective case-control design. We searched our electronic medical records for patients who received spinal anesthesia for cesarean delivery, and were SARS-CoV-2 positive or recovered at delivery, and used historical and SARS-CoV-2 negative controls from two tertiary care hospitals. We compared the demographic, clinical, and hemodynamic variables between patients who were SARS-CoV-2 positive at delivery, those who were positive during pregnancy and recovered before delivery, and controls. Analyses were stratified by normotensive versus hypertensive status of the patients at delivery. We identified 22 SARS-CoV-2 positive, 73 SARS-CoV-2 recovered, and 1517 controls. The SARS-CoV-2 positive, and recovered pregnant patients, had on average 5.6 and 2.2 mmHg, respectively, higher post-spinal mean arterial pressures (MAPs) than control patients, adjusting for covariates. Additionally, the lowest post-spinal MAP was negatively correlated with the number of days between the onset of COVID-19 symptoms and delivery in patients with hypertension (correlation −0.55, 95% CI −0.81 to −0.09). Patients with SARS-CoV-2 infection during pregnancy exhibit less spinal hypotension than non-infected patients. While the clinical significance of this finding is unknown, it points to important cardiovascular effects of the virus.
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影响因子：
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作者：
Celik M;Yilmaz Y;Karagoz A;Kahyaoglu M;Cakmak EO;Kup A;Celik FB;Karaduman A;Kulahcioglu S;Izci S;Gecmen C;Caliskan M
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影响因子：
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作者：
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10.1016/j.jstrokecerebrovasdis.2020.105357
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2020-12
期刊：
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
影响因子：
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作者：
P V S;Rai A;Wadhwa C
通讯作者：
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Feldt-Rasmussen U