Myocardial Injury Is Associated with Higher Morbidity and Mortality in Patients with 2019 Novel Coronavirus Disease (COVID-19).
Myocardial Injury Is Associated with Higher Morbidity and Mortality in Patients with 2019 Novel Coronavirus Disease (COVID-19).
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DOI：
10.1007/s42399-020-00569-6
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Mohamed Elfadil O
中科院分区：
文献类型：
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作者：
Al-Wahaibi K;Al-Wahshi Y;Mohamed Elfadil O
COVID-19大流行是一场全球性的健康灾难，自二零一九年十二月出现以来，已导致地球仪各地出现大量发病率及死亡率。研究表明，与COVID-19相关的心血管表现和并发症可归因于不利的临床结果和不良预后。纳入了2020年3月至6月期间需要在参与中心住院的实验室确诊COVID-19成人患者。收集的数据包括人口统计学、实验室检查结果、合并症、治疗和干预措施。比较了有和无心脏损伤患者的死亡率和临床结局。共纳入143例确诊为COVID-19的住院患者（86.7%为男性;年龄49.36 ± 15.32岁）。在34.3%的研究人群中观察到心血管疾病（CVD），包括高血压、心肌病、冠心病和心律失常，21.7%的研究人群有心脏损伤。与无心脏损伤的患者相比，有心脏损伤的患者年龄更大（59 [33-89] vs 47 [22-94]岁; P < 0.0001），并有更多的合并症和心血管（CV）风险因素（高血压61.3% vs 24.1%; P < 0.0001，慢性心力衰竭16.1% vs 0%; P < 0.00001，糖尿病54.8% vs 31.3%; P 0.015，COPD/哮喘19.4% vs 3.6%; P 0.002）;更多的心脏损伤患者需要有创机械通气（77.4% vs 38.4%; P 0.00012）。合并心脏损伤患者的并发症发生率高于无心脏损伤患者，包括急性呼吸窘迫综合征（87% vs 42.9%; P < 0.00001）、急性肾损伤（67.7% vs 11.6%; P < 0.00001）和贫血（38.7% vs 3.6%;P < 0.00001）。心脏损伤患者的肾脏替代治疗需求也较高（48.4% vs 3.6%; P < 0.00001）。有心脏损伤者病死率明显高于无心脏损伤者（53.3%vs7.1%，P < 0.00001）。总之，心肌损伤在阿曼的COVID-19住院患者中常见，与具有更多CV风险因素和合并症的老年患者相关，并且与较高的住院死亡率和不利的临床结局风险相关。
COVID-19 pandemic, a global health disaster, has resulted in substantial morbidity and mortality across the globe since emerging on December 2019. Studies have shown that cardiovascular manifestations and complications linked to COVID-19 can be attributed to unfavorable clinical outcome and poor prognosis. Adult patients with laboratory-confirmed COVID-19 requiring hospitalization in participating centers between March and June 2020 were included. Data including demographics, laboratory findings, comorbidities, treatments and interventions were collected. Mortality and clinical outcomes in patients with and without cardiac injury were compared. A total of 143 hospitalized patients with confirmed COVID-19 were included (86.7% male; age 49.36 ± 15.32 years). Cardiovascular diseases (CVDs) including hypertension, cardiomyopathy, coronary heart disease, and rhythm disturbances were noted in 34.3% of the study population and 21.7% had cardiac injury. In comparison with patients without cardiac injury, patients with cardiac injury were older (59 [33–89] vs 47 [22–94] years; P < 0.0001) and had more co-morbidities and cardiovascular (CV) risk factors (hypertension in 61.3% vs 24.1%; P < 0.0001, chronic heart failure in 16.1% vs 0%; P < 0.00001, diabetes mellitus 54.8% vs 31.3%; P 0.015, COPD/asthma 19.4% vs 3.6%; P 0.002); more patients with cardiac injury required invasive mechanical ventilation (77.4% vs 38.4%; P 0.00012). Complications were more prevalent in patients with cardiac injury than those without cardiac injury and included acute respiratory distress syndrome (87% vs 42.9%; P < 0.00001), acute kidney injury (67.7% vs 11.6%; P < 0.00001), and anemia (38.7% vs 3.6%;P < 0.00001). The need for renal replacement therapy was also higher in patients with cardiac injury (48.4% vs 3.6%; P < 0.00001). Noticeably, patients with cardiac injury had higher mortality than those without cardiac injury (53.3% vs 7.1%; P < 0.00001). In summary, myocardial injury is common among hospitalized patients with COVID-19 in Oman in relation to older patients with more CV risk factors and comorbidities, and is associated with higher risk of in-hospital mortality and unfavorable clinical outcomes.