Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
Department of Plastic Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
Heart. 2020 Aug;106(15):1148-1153. doi: 10.1136/heartjnl-2020-316909. Epub 2020 May 25.
An outbreak of the highly contagious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has sickened thousands of people in China. The purpose of this study was to explore the early clinical characteristics of COVID-19 patients with cardiovascular disease (CVD).
This is a retrospective analysis of patients with COVID-19 from a single centre. All patients underwent real-time reverse transcription PCR for SARS-CoV-2 on admission. Demographic and clinical factors and laboratory data were reviewed and collected to evaluate for significant associations.
The study included 541 patients with COVID-19. A total of 144 (26.6%) patients had a history of CVD. The mortality of patients with CVD reached 22.2%, which was higher than that of the overall population of this study (9.8%). Patients with CVD were also more likely to develop liver function abnormality, elevated blood creatinine and lactic dehydrogenase (p<0.05). Symptoms of sputum production were more common in patients with CVD (p=0.026). Lymphocytes, haemoglobin and albumin below the normal range were pervasive in the CVD group (p<0.05). The proportion of critically ill patients in the CVD group (27.8%) was significantly higher than that in the non-CVD group (8.8%). Multivariable logistic regression analysis revealed that CVD (OR: 2.735 (95% CI 1.495 to 5.003), p=0.001) was associated with critical COVID-19 condition, while patients with coronary heart disease were less likely to reach recovery standards (OR: 0.331 (95% CI 0.125 to 0.880), p=0.027).
Considering the high prevalence of CVD, a thorough CVD assessment at diagnosis and early intervention are recommended in COVID-19 patients with CVD. Patients with CVD are more vulnerable to deterioration.
一种具有高度传染性的严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)在中国已使数千人患病。本研究旨在探讨合并心血管疾病(CVD)的 COVID-19 患者的早期临床特征。
这是一项对单一中心的 COVID-19 患者进行的回顾性分析。所有患者在入院时均接受 SARS-CoV-2 的实时逆转录 PCR 检测。回顾和收集人口统计学和临床因素及实验室数据,以评估其显著相关性。
该研究共纳入 541 例 COVID-19 患者。共有 144 例(26.6%)患者有 CVD 病史。CVD 患者的死亡率达到 22.2%,高于本研究总体人群的死亡率(9.8%)。CVD 患者更易发生肝功能异常、血肌酐和乳酸脱氢酶升高(p<0.05)。CVD 患者更常出现咳痰症状(p=0.026)。CVD 组淋巴细胞、血红蛋白和白蛋白低于正常值的比例较高(p<0.05)。CVD 组(27.8%)危重症患者的比例明显高于非 CVD 组(8.8%)。多变量逻辑回归分析显示,CVD(OR:2.735(95%CI 1.495 至 5.003),p=0.001)与严重 COVID-19 状况相关,而冠心病患者更不可能达到康复标准(OR:0.331(95%CI 0.125 至 0.880),p=0.027)。
鉴于 CVD 的高患病率,建议对 COVID-19 合并 CVD 的患者进行全面的 CVD 评估和早期干预。CVD 患者更容易恶化。