Institute of Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Department of Molecular and Translational Medicine, University of Brescia, Brescia Italy.
Eur Heart J. 2020 May 14;41(19):1821-1829. doi: 10.1093/eurheartj/ehaa388.
To compare demographic characteristics, clinical presentation, and outcomes of patients with and without concomitant cardiac disease, hospitalized for COVID-19 in Brescia, Lombardy, Italy.
The study population includes 99 consecutive patients with COVID-19 pneumonia admitted to our hospital between 4 March and 25 March 2020. Fifty-three patients with a history of cardiac disease were compared with 46 without cardiac disease. Among cardiac patients, 40% had a history of heart failure, 36% had atrial fibrillation, and 30% had coronary artery disease. Mean age was 67 ± 12 years, and 80 (81%) patients were males. No differences were found between cardiac and non-cardiac patients except for higher values of serum creatinine, N-terminal probrain natriuretic peptide, and high sensitivity troponin T in cardiac patients. During hospitalization, 26% patients died, 15% developed thrombo-embolic events, 19% had acute respiratory distress syndrome, and 6% had septic shock. Mortality was higher in patients with cardiac disease compared with the others (36% vs. 15%, log-rank P = 0.019; relative risk 2.35; 95% confidence interval 1.08-5.09). The rate of thrombo-embolic events and septic shock during the hospitalization was also higher in cardiac patients (23% vs. 6% and 11% vs. 0%, respectively).
Hospitalized patients with concomitant cardiac disease and COVID-19 have an extremely poor prognosis compared with subjects without a history of cardiac disease, with higher mortality, thrombo-embolic events, and septic shock rates.
比较意大利伦巴第布雷西亚因 COVID-19 住院的合并心脏病和无合并心脏病患者的人口统计学特征、临床表现和结局。
研究人群包括 2020 年 3 月 4 日至 3 月 25 日期间我院收治的 99 例连续 COVID-19 肺炎患者。将 53 例有心脏病史的患者与 46 例无心脏病史的患者进行比较。在心脏病患者中，40%有心力衰竭史，36%有心房颤动史，30%有冠状动脉疾病史。平均年龄为 67 ± 12 岁，80 例（81%）为男性。除了心脏病患者的血清肌酐、N 端脑利钠肽前体和高敏肌钙蛋白 T 值较高外，两组患者间无差异。住院期间，26%的患者死亡，15%发生血栓栓塞事件，19%发生急性呼吸窘迫综合征，6%发生感染性休克。合并心脏病的患者死亡率高于无心脏病史的患者（36% vs. 15%，log-rank P = 0.019；相对风险 2.35；95%置信区间 1.08-5.09）。合并心脏病的患者在住院期间发生血栓栓塞事件和感染性休克的比率也高于无心脏病史的患者（23% vs. 6%和 11% vs. 0%）。
与无心脏病史的患者相比，合并心脏病和 COVID-19 的住院患者预后极差，死亡率、血栓栓塞事件和感染性休克的发生率更高。
