Chen C, Chen C, Yan J T, Zhou N, Zhao J P, Wang D W
Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2020 Jul 24;48(7):567-571. doi: 10.3760/cma.j.cn112148-20200225-00123.
To evaluate the cardiovascular damage of patients with COVID-19, and determine the correlation of serum N-terminal pro B-type natriuretic peptide (NT-proBNP） and cardiac troponin-I (cTnI） with the severity of COVID-19, and the impact of concomitant cardiovascular disease on severity of COVID-19 was also evaluated. A cross-sectional study was designed on 150 consecutive patients with COVID-19 in the fever clinic of Tongji Hospital in Wuhan from January 19 to February 13 in 2020, including 126 mild cases and 24 cases in critical care. Both univariate and multivariate logistic regression were used to analyze the correlation of past medical history including hypertension, diabetes and coronary heart disease (CHD）, as well as the levels of serum NT-proBNP and cTnI to the disease severity of COVID-19 patients. Age, hypersensitive C-reactive protein(hs-CRP) and serum creatinine levels of the patients were higher in critical care cases than in mild cases(all <0.05). Prevalence of male, elevated NT-proBNP and cTnI, hypertension and coronary heart disease were significantly higher in critical cases care patients than in the mild cases(all <0.05). Univariate logistic regression analysis showed that age, male, elevated NT-proBNP, elevated cTnI, elevated hs-CRP, elevated serum creatinine, hypertension, and CHD were significantly correlated with critical disease status(all <0.05). Multivariate logistic regression analysis showed that elevated cTnI(=26.909，95% 4.086-177.226，=0.001) and CHD (=16.609，95% 2.288-120.577，=0.005) were the independent risk factors of critical disease status. COVID-19 can significantly affect the heart function and lead to myocardial injury. The past medical history of CHD and increased level of cTnI are 2 independent determinants of clinical disease status in patients with COVID-19.
为评估新型冠状病毒肺炎（COVID-19）患者的心血管损害情况，确定血清N末端B型利钠肽原（NT-proBNP）和心肌肌钙蛋白I（cTnI）与COVID-19严重程度的相关性，并评估合并心血管疾病对COVID-19严重程度的影响。对2020年1月19日至2月13日在武汉同济医院发热门诊连续收治的150例COVID-19患者进行横断面研究，其中轻症126例，危重症24例。采用单因素和多因素logistic回归分析高血压、糖尿病和冠心病（CHD）等既往病史以及血清NT-proBNP和cTnI水平与COVID-19患者疾病严重程度的相关性。危重症患者的年龄、超敏C反应蛋白（hs-CRP）和血清肌酐水平均高于轻症患者（均P<0.05）。危重症患者中男性、NT-proBNP和cTnI升高、高血压和冠心病的患病率均显著高于轻症患者（均P<0.05）。单因素logistic回归分析显示，年龄、男性、NT-proBNP升高、cTnI升高、hs-CRP升高、血清肌酐升高、高血压和CHD与危重症状态显著相关（均P<0.05）。多因素logistic回归分析显示，cTnI升高（β=26.909，95%CI 4.086-177.226，P=0.001）和CHD（β=16.609，95%CI 2.288-120.577,P=0.005）是危重症状态的独立危险因素。COVID-19可显著影响心脏功能并导致心肌损伤。CHD既往病史和cTnI水平升高是COVID-19患者临床疾病状态的2个独立决定因素。
