Key factors leading to fatal outcomes in COVID-19 patients with cardiac injury.
Key factors leading to fatal outcomes in COVID-19 patients with cardiac injury.
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导致心脏损伤的 COVID-19 患者死亡的关键因素
DOI：
10.1038/s41598-021-82396-w
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发表时间：
2021-02-18
影响因子：
4.6
通讯作者：
Jiang X
中科院分区：
文献类型：
--
作者：
He Y;Zheng X;Li X;Jiang X
新冠肺炎患者中的心脏损伤已有报道，并与高死亡风险相关，但心脏损伤可能不是与死亡相关的主要因素。新冠肺炎合并心肌损伤患者预后不良的相关因素尚不清楚。本研究旨在探讨新冠肺炎心脏损伤患者院内死亡的潜在关键因素。本研究于2020年1月20日至2020年4月10日在武汉大学人民医院中国院内完成。纳入所有确诊为新冠肺炎(≥ )的住院患者(18岁)，并于2020年4月10日前死亡或出院的心脏损伤患者。收集人口学数据以及临床和实验室结果，并对幸存者和死亡者进行比较。采用单因素和多因素Logistic回归分析方法，探讨新冠肺炎心脏损伤患者死亡的危险因素。纳入本研究的新冠肺炎心脏损伤患者173例，出院86例，住院死亡87例。多因素回归分析显示，高龄(优势比1.12，95%可信区间1.05~1.18，每年增加；P<； 0.001)、凝血障碍(2.54，1.26~5.12；p= 0.009)、急性呼吸窘迫综合征(16.56，6.66~41.2；p<； 0.001)和超敏肌钙蛋白I升高(4.54，1.79~11.48；p= 0.001)与住院死亡有关。在这项研究中，新冠肺炎心脏损伤患者存在较高的住院死亡风险。与死亡相关的因素包括高龄、凝血障碍、急性呼吸窘迫综合征和超敏肌钙蛋白I水平升高。
Cardiac injury among patients with COVID-19 has been reported and is associated with a high risk of mortality, but cardiac injury may not be the leading factor related to death. The factors related to poor prognosis among COVID-19 patients with myocardial injury are still unclear. This study aimed to explore the potential key factors leading to in-hospital death among COVID-19 patients with cardiac injury. This retrospective single-center study was conducted at Renmin Hospital of Wuhan University, from January 20, 2020 to April 10, 2020, in Wuhan, China. All inpatients with confirmed COVID-19 (≥ 18 years old) and cardiac injury who had died or were discharged by April 10, 2020 were included. Demographic data and clinical and laboratory findings were collected and compared between survivors and nonsurvivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with mortality in COVID-19 patients with cardiac injury. A total of 173 COVID-19 patients with cardiac injury were included in this study, 86 were discharged and 87 died in the hospital. Multivariable regression showed increased odds of in-hospital death were associated with advanced age (odds ratio 1.12, 95% CI 1.05–1.18, per year increase;p< 0.001), coagulopathy (2.54, 1.26–5.12;p= 0·009), acute respiratory distress syndrome (16.56, 6.66–41.2;p< 0.001), and elevated hypersensitive troponin I (4.54, 1.79–11.48;p= 0.001). A high risk of in-hospital death was observed among COVID-19 patients with cardiac injury in this study. The factors related to death include advanced age, coagulopathy, acute respiratory distress syndrome and elevated levels of hypersensitive troponin I.
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