The role of concomitant cardiovascular diseases and cardiac biomarkers for predicting mortality in critical COVID-19 patients
The role of concomitant cardiovascular diseases and cardiac biomarkers for predicting mortality in critical COVID-19 patients
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DOI：
10.1080/00015385.2020.1810914
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发表时间：
2020-09-01
影响因子：
1.6
通讯作者：
Atabey, Rukiye Derin
中科院分区：
文献类型：
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作者：
Aladag, Nesim;Atabey, Rukiye Derin
背景：确定与住院COVID-19患者死亡率相关的潜在心血管风险因素。方法纳入2020年4月1日至2020年5月20日因COVID-19入住我院重症监护室（ICU）的所有连续患者。比较幸存者和非幸存者的患者特征，包括完整的病史和共病，入院和第7天的血液检查结果和临床特征。结果存活组与死亡组在年龄、性别、既往冠状动脉疾病、高血压、糖尿病、心力衰竭、冠状动脉旁路移植术、经皮冠状动脉介入治疗和冠状动脉支架植入术等方面差异无统计学意义。死亡组入院时D-二聚体和NT-proBNP水平明显高于存活组。入院第7天，非幸存者的CRP、降钙素原、肌酸激酶（CK）和肌钙蛋白I水平显著高于幸存者。此外，入院和第7天淋巴细胞计数均低于非幸存者的幸存者。生存者从入院到住院第7天CRP下降，而非生存者中位值增加6.75 mg/L。非幸存者的CRP、降钙素原和水平的峰值和最小值均显著高于幸存者。死亡组NT-proBNP峰值明显高于存活组。插管、较低的GFR值和较高的NT-proBNP值预测死亡。结论内皮细胞与SARS-CoV-2相互作用介导的血栓前凝血功能障碍可能也是COVID-19预后不良的原因之一。这些容易获得的生物标志物可能有助于COVID-19病例的风险分层。
Background to identify the potential cardiovascular risk factors associated with mortality in hospitalised COVID-19 patients. Methods All consecutive patients admitted to intensive care unit (ICU) of our institute for COVID-19 from 1 April 2020 to 20 May 2020 were included. Patient characteristics including complete medical history and comorbid diseases, admission and 7th day blood test results and clinical characteristics were compared between survivors and non-survivors. Results There were no significant difference between survivors and non-survivors regarding age, gender, and pre-existing coronary artery disease, hypertension, diabetes, heart failure, coronary artery bypass grafting surgery, percutaneous coronary intervention and coronary stenting. Admission D-dimer and NT-proBNP levels of non-survivors were significantly higher than survivors. CRP, procalcitonin, creatine kinase (CK) and troponin I levels on 7th day of admission were significantly higher in non-survivors compared to survivors. In addition, both admission and 7th day lymphocyte count were lower in non-survivors compared to that of the survivors. CRP declined from admission to 7th day of hospitalisation in survivors, whereas a median 6.75 mg/L increase was observed in non survivors. The peak and minimum CRP, procalcitonin and levels were significantly higher in non-survivors than survivors. The peak NT-proBNP level of non-survivors was also significantly higher than that of the survivors. Intubation, lower GFR values and higher NT-proBNP values were predictive for death. Conclusion The prothrombotic coagulopathy mediated by the endothelial interaction with SARS-CoV-2 may also have role in unfavourable prognosis in COVID-19. These readily available biomarkers might be useful in risk stratification of COVID-19 cases.