Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China
Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China
复制标题
中国武汉市 COVID-19 住院患者心脏损伤与死亡率的关系
DOI：
10.1001/jamacardio.2020.0950
复制
发表时间：
2020-07-01
期刊：
影响因子：
24
通讯作者：
Huang, Congxin
中科院分区：
文献类型：
--
作者：
Shi, Shaobo;Qin, Mu;Huang, Congxin
问题COVID-19患者心脏损伤的发生率和意义是什么？在这项对416名确诊COVID-19的连续患者进行的队列研究中，19. 7%的患者在住院期间发生心脏损伤，这是住院死亡率的一个独立风险因素。意义心脏损伤是COVID-19住院患者的常见疾病，与住院死亡风险较高相关。这项队列研究于2020年1月20日至2020年2月10日在中国武汉进行，探讨COVID-19住院患者心脏损伤的患病率及其与死亡率的关系。重要性2019年冠状病毒病自二零一九年十二月以来，新冠肺炎疫情已导致全球范围内出现相当高的发病率及死亡率。然而，关于受COVID-19影响的患者心脏损伤的信息有限。目的探讨COVID-19患者心脏损伤与死亡率的关系。设计、设置和参与者本队列研究于2020年1月20日至2020年2月10日在中国武汉市武汉大学人民医院的单中心进行;最终随访日期为2020年2月15日。所有实验室确诊的COVID-19连续住院患者均纳入本研究。主要结果和测量临床实验室，放射学和治疗数据进行收集和分析。比较有无心脏损伤患者的结局。分析心脏损伤与死亡率之间的关系。结果最终分析共纳入416例COVID-19住院患者;中位年龄为64岁（范围，21-95岁），211例（50.7%）为女性。常见症状包括发热（334例患者[80.3%]）、咳嗽（144例[34.6%]）和呼吸急促（117例[28.1%]）。共82名患者（19.7%）有心脏损伤，与无心脏损伤的患者相比，这些患者年龄较大（中位[范围]年龄，74 [34-95] vs 60 [21-90]岁; P < .001）;有更多的合并症（例如，82例患者中有49例[59.8%]患有高血压，334例患者中有78例[23.4%]患有高血压; P < .001）;白细胞计数较高（中位数[四分位距（IQR）]，9400 [6900-13 & x202 f; 800] vs 5500 [4200-7400]个细胞/μ L）和C反应蛋白水平（中位数[IQR]，10.2 [6.4-17.0] vs 3.7 [1.0-7.3] mg/dL），降钙素原（中位数[IQR]，0.27 [0.10-1.22] vs 0.06 [0.03-0.10] ng/mL），肌酐激酶-心肌带（中位数[IQR]，3.2 [1.8-6.2] vs 0.9 [0.6-1.3] ng/mL）、肌血红蛋白（中位数[IQR]，128 [68-305] vs 39 [27-65] μ g/L）、高敏肌钙蛋白I（中位数[IQR]，0.19 [0.08-1.12] vs
Question What is the incidence and significance of cardiac injury in patients with COVID-19? Findings In this cohort study of 416 consecutive patients with confirmed COVID-19, cardiac injury occurred in 19.7% of patients during hospitalization, and it was one independent risk factor for in-hospital mortality. Meaning Cardiac injury is a common condition among patients hospitalized with COVID-19, and it is associated with higher risk of in-hospital mortality.This cohort study, conducted from January 20, 2020, to February 10, 2020, in Wuhan, China, explores the prevalence of cardiac injury in hospitalized patients with COVID-19 and its association with mortality.Importance Coronavirus disease 2019 (COVID-19) has resulted in considerable morbidity and mortality worldwide since December 2019. However, information on cardiac injury in patients affected by COVID-19 is limited. Objective To explore the association between cardiac injury and mortality in patients with COVID-19. Design, Setting, and Participants This cohort study was conducted from January 20, 2020, to February 10, 2020, in a single center at Renmin Hospital of Wuhan University, Wuhan, China; the final date of follow-up was February 15, 2020. All consecutive inpatients with laboratory-confirmed COVID-19 were included in this study. Main Outcomes and Measures Clinical laboratory, radiological, and treatment data were collected and analyzed. Outcomes of patients with and without cardiac injury were compared. The association between cardiac injury and mortality was analyzed. Results A total of 416 hospitalized patients with COVID-19 were included in the final analysis; the median age was 64 years (range, 21-95 years), and 211 (50.7%) were female. Common symptoms included fever (334 patients [80.3%]), cough (144 [34.6%]), and shortness of breath (117 [28.1%]). A total of 82 patients (19.7%) had cardiac injury, and compared with patients without cardiac injury, these patients were older (median [range] age, 74 [34-95] vs 60 [21-90] years; P < .001); had more comorbidities (eg, hypertension in 49 of 82 [59.8%] vs 78 of 334 [23.4%]; P < .001); had higher leukocyte counts (median [interquartile range (IQR)], 9400 [6900-13 & x202f;800] vs 5500 [4200-7400] cells/mu L) and levels of C-reactive protein (median [IQR], 10.2 [6.4-17.0] vs 3.7 [1.0-7.3] mg/dL), procalcitonin (median [IQR], 0.27 [0.10-1.22] vs 0.06 [0.03-0.10] ng/mL), creatinine kinase-myocardial band (median [IQR], 3.2 [1.8-6.2] vs 0.9 [0.6-1.3] ng/mL), myohemoglobin (median [IQR], 128 [68-305] vs 39 [27-65] mu g/L), high-sensitivity troponin I (median [IQR], 0.19 [0.08-1.12] vs