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COVID-19 相关心脏损伤:对幸存者长期监测和结局的影响。

COVID-19 cardiac injury: Implications for long-term surveillance and outcomes in survivors.

机构信息

Cardiovascular Division, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida.

Cardiovascular Division, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida.

出版信息

Heart Rhythm. 2020 Nov;17(11):1984-1990. doi: 10.1016/j.hrthm.2020.06.026. Epub 2020 Jun 26.

Abstract

Up to 20%-30% of patients hospitalized with coronavirus disease 2019 (COVID-19) have evidence of myocardial involvement. Acute cardiac injury in patients hospitalized with COVID-19 is associated with higher morbidity and mortality. There are no data on how acute treatment of COVID-19 may affect the convalescent phase or long-term cardiac recovery and function. Myocarditis from other viral pathogens can evolve into overt or subclinical myocardial dysfunction, and sudden death has been described in the convalescent phase of viral myocarditis. This raises concerns for patients recovering from COVID-19. Some patients will have subclinical and possibly overt cardiovascular abnormalities. Patients with ostensibly recovered cardiac function may still be at risk of cardiomyopathy and cardiac arrhythmias. Screening for residual cardiac involvement in the convalescent phase for patients recovered from COVID-19-associated cardiac injury is needed. The type of testing and therapies for post COVID-19 myocardial dysfunction will need to be determined. Therefore, now is the time to plan for appropriate registries and clinical trials to properly assess these issues and prepare for long-term sequelae of "post-COVID-19 cardiac syndrome."

摘要

多达 20%-30%因 2019 冠状病毒病(COVID-19)住院的患者有心肌受累的证据。COVID-19 住院患者的急性心脏损伤与更高的发病率和死亡率相关。关于 COVID-19 的急性治疗如何影响恢复期或长期心脏恢复和功能,目前尚无数据。其他病毒病原体引起的心肌炎可发展为显性或亚临床心功能障碍,并且已在病毒心肌炎的恢复期描述了猝死。这引起了对 COVID-19 恢复期患者的担忧。一些患者将有亚临床和可能显性的心血管异常。表面上心脏功能恢复的患者仍有心肌病和心律失常的风险。需要对 COVID-19 相关心脏损伤后康复的患者进行恢复期残留心脏受累的筛查。需要确定用于 COVID-19 后心肌功能障碍的检测和治疗类型。因此,现在是时候为适当的登记册和临床试验做好规划,以正确评估这些问题并为“COVID-19 后心脏综合征”的长期后果做好准备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bd5/7319645/3adc86ecc111/gr1_lrg.jpg

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