Increased Creatine Kinase May Predict A Worse COVID-19 Outcome.
Increased Creatine Kinase May Predict A Worse COVID-19 Outcome.
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DOI：
10.3390/jcm10081734
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发表时间：
2021-04-16
影响因子：
3.9
通讯作者：
Volpi G
中科院分区：
文献类型：
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作者：
Orsucci D;Trezzi M;Anichini R;Blanc P;Barontini L;Biagini C;Capitanini A;Comeglio M;Corsini P;Gemignani F;Giannecchini R;Giusti M;Lombardi M;Marrucci E;Natali A;Nenci G;Vannucci F;Volpi G
来自亚洲的早期报告表明，血清肌酸磷酸激酶(CK/CPK)水平升高可能与新冠肺炎预后更差有关。这项单中心回顾性队列研究的目的是验证这种关系，并评估可能的混杂因素(年龄、体重指数、性别和合并症)的作用。我们根据“重度”(n=99)或“轻度”(n=232)的结果将我们的队列细分为两组。“重度”疾病在这里被定义为死亡和/或机械有创呼吸机，与之形成对比的是“轻度”患者，即活着出院而不需要有创呼吸机；后者也可以包括那些接受无创呼吸机治疗的患者。入院时CK水平较高的患者预后较差(中位数为126U/L，范围为10-1672U/L，中位数为82；范围为12-1499U/L，P=0.01)，且高CK血症和GT；200U/L与较差的预后相关。回归分析证实，CK升高是“严重”结局的独立预测因子。高CK血症一般都是一过性的，在住院期间大多数“重度”和“轻度”患者都恢复到正常水平。虽然随意肌的直接感染尚未得到证实，但在新冠肺炎的过程中，一过性肌肉功能障碍是常见的。这种新型冠状病毒对随意肌的影响确实需要澄清。
Early reports from Asia suggested that increased serum levels of the muscular enzyme creatine-(phospho)-kinase (CK/CPK) could be associated with a more severe prognosis in COVID-19. The aim of this single-center retrospective cohort study of 331 consecutive COVID-19 patients who were hospitalized during Italy’s “first wave” was to verify this relationship, and to evaluate the role of possible confounding factors (age, body mass index, gender, and comorbidities). We subdivided our cohort in two groups, based on “severe” (n = 99) or “mild” (n = 232) outcomes. “Severe” disease is defined here as death and/or mechanical invasive ventilation, in contrast to “mild” patients, who were discharged alive with no need for invasive ventilation; this latter group could also include those patients who were treated with non-invasive ventilation. The CK levels at admission were higher in those subjects who later experienced more severe outcomes (median, 126; range, 10–1672 U/L, versus median, 82; range, 12–1499 U/L, p = 0.01), and hyperCKemia >200 U/L was associated with a worse prognosis. Regression analysis confirmed that increased CK acted as an independent predictor for a “severe” outcome. HyperCKemia was generally transient, returning to normal during hospitalization in the majority of both “severe” and “mild” patients. Although the direct infection of voluntary muscle is unproven, transient muscular dysfunction is common during the course of COVID-19. The influence of this novel coronavirus on voluntary muscle really needs to be clarified.
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影响因子：
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作者：
Orsucci, Daniele;Ienco, Elena Caldarazzo;Vista, Marco
通讯作者：
Vista, Marco
影响因子：
--
作者：
Mudatsir, Mudatsir;Fajar, Jonny Karunia;Harapan, Harapan
通讯作者：
Harapan, Harapan
影响因子：
3.7
作者：
Zhang XB;Hu L;Ming Q;Wei XJ;Zhang ZY;Chen LD;Wang MH;Yao WZ;Huang QF;Ye ZQ;Cai YQ;Zeng HQ
通讯作者：
Zeng HQ
DOI：
10.1177/2324709620984603
发表时间：
2020-01
影响因子：
1.2
作者：
Khosla SG;Nylen ES;Khosla R
通讯作者：
Khosla R
影响因子：
36.4
作者：
Dolhnikoff, Marisa;Ferranti, Juliana Ferreira;Caldini, Elia Garcia
通讯作者：
Caldini, Elia Garcia