He Feng, Quan Yibo, Lei Ming, Liu Riguang, Qin Shuguang, Zeng Jun, Zhao Ziwen, Yu Na, Yang Liuping, Cao Jie
1Guangzhou First People's Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou, China.
2Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
Aging Dis. 2020 Jul 23;11(4):763-769. doi: 10.14336/AD.2020.0622. eCollection 2020 Jul.
Previous studies on coronavirus disease 2019 (COVID-19) have focused on the general population. However, cardiovascular disease (CVD) is a common comorbidity that has rarely been investigated in detail. This study aims to describe clinical characteristics and determine risk factors for intensive care unit (ICU) admission of COVID-19 patients with CVD. In this retrospective cohort study, we included 288 adult patients with COVID-19 in Guangzhou Eighth People's Hospital from January 15, 2020 to March 10, 2020. Demographic characteristics, laboratory results, radiographic findings, complications, and treatments were recorded and compared between CVD and non-CVD groups. A binary logistic regression model was used to identify risk factors associated with ICU admission for infected patients with underlying CVD. COVID-19 patients in the CVD group were older and had higher levels of troponin I (TnI), C-reactive protein (CRP), and creatinine. They were also more prone to develop into severe or critically severe cases, receive ICU admission, and require respiratory support treatment. Multivariate regression analysis showed that the following were risk factors for ICU admission in COVID-19 patients with CVD: each 1-year increase in age (odds ratio (OR), 1.08; 95% confidence interval (CI), 1.02-1.17; p = 0.018); respiratory rate over 24 times per min (OR, 25.52; 95% CI, 5.48-118.87; p < 0.0001); CRP higher than 10 mg/L (OR, 8.12; 95% CI, 1.63-40.49; p = 0.011); and TnI higher than 0.03 μg/L (OR, 9.14; 95% CI, 2.66-31.43; p < 0.0001). Older age, CRP greater than 10 mg/L, TnI higher than 0.03 μg/L, and respiratory rate over 24 times per minute were associated with increasing odds of ICU admission in COVID-19 patients with CVD. Investigating and monitoring these factors could assist in the risk stratification of COVID-19 patients with CVD at an early stage.
先前关于2019冠状病毒病（COVID-19）的研究主要集中在普通人群。然而，心血管疾病（CVD）是一种常见的合并症，很少有研究对其进行详细调查。本研究旨在描述COVID-19合并CVD患者的临床特征，并确定其入住重症监护病房（ICU）的危险因素。在这项回顾性队列研究中，我们纳入了2020年1月15日至2020年3月10日期间在广州市第八人民医院就诊的288例成年COVID-19患者。记录并比较了CVD组和非CVD组的人口统计学特征、实验室检查结果、影像学表现、并发症及治疗情况。采用二元逻辑回归模型确定合并CVD的感染患者入住ICU的相关危险因素。CVD组的COVID-19患者年龄更大，肌钙蛋白I（TnI）、C反应蛋白（CRP）和肌酐水平更高。他们也更容易发展为重症或危重症病例，需要入住ICU并接受呼吸支持治疗。多因素回归分析显示，以下因素是合并CVD的COVID-19患者入住ICU的危险因素：年龄每增加1岁（比值比（OR），1.08；95%置信区间（CI），1.02-1.17；p = 0.018）；呼吸频率每分钟超过24次（OR，25.52；95%CI，5.48-118.87；p < 0.0001）；CRP高于10 mg/L（OR，8.12；95%CI，1.63-40.49；p = 0.011）；TnI高于0.03 μg/L（OR，9.14；95%CI，2.66-31.43；p < 0.0001）。年龄较大、CRP大于10 mg/L、TnI高于0.03 μg/L以及呼吸频率每分钟超过24次与合并CVD的COVID-19患者入住ICU的几率增加相关。对这些因素进行调查和监测有助于在早期对合并CVD的COVID-19患者进行风险分层。
