Department of Cardiology, the General Hospital of Central Theater Command, Wuhan, 430000, China.
Department of Integrated Traditional Chinese and Western Internal Medicine, the General Hospital of Central Theater Command, Wuhan, 430000, China.
BMC Infect Dis. 2020 Oct 22;20(1):787. doi: 10.1186/s12879-020-05452-2.
A cluster of acute respiratory illness, now known as Corona Virus Disease 2019 (COVID-19) caused by 2019 novel coronavirus (SARS-CoV-2), has become a global pandemic. Aged population with cardiovascular diseases are more likely be to infected with SARS-CoV-2 and result in more severe outcomes and elevated case-fatality rate. Meanwhile, cardiovascular diseases have a high prevalence in the middle-aged and elderly population. However, despite of several researches in COVID-19, cardiovascular implications related to it still remains largely unclear. Therefore, a specific analysis in regard to cardiovascular implications of COVID-19 patients is in great need.
In this single-centered, retrospective, observational study, 116 patients with laboratory-confirmed COVID-19 were enrolled, who admitted to the General Hospital of Central Theater Command (Wuhan, China) from January 20 to March 8, 2020. The demographic data, underlying comorbidities, clinical symptoms and signs, laboratory findings, chest computed tomography, treatment measures, and outcome data were collected from electronic medical records. Data were compared between non-severe and severe cases.
Of 116 hospitalized patients with COVID-19, the median age was 58.5 years (IQR, 47.0-69.0), and 36 (31.0%) were female. Hypertension (45 [38.8%]), diabetes (19 [16.4%]), and coronary heart disease (17 [14.7%]) were the most common coexisting conditions. Common symptoms included fever [99 (85.3%)], dry cough (61 [52.6%]), fatigue (60 [51.7%]), dyspnea (52 [44.8%]), anorexia (50 [43.1%]), and chest discomfort (50 [43.1%]). Local and/or bilateral patchy shadowing were the typical radiological findings on chest computed tomography. Lymphopenia (lymphocyte count, 1.0 × 10/L [IQR, 0.7-1.3]) was observed in 66 patients (56.9%), and elevated lactate dehydrogenase (245.5 U/L [IQR, 194.3-319.8]) in 69 patients (59.5%). Hypokalemia occurred in 24 (20.7%) patients. Compared with non-severe cases, severe cases were older (64.0 years [IQR, 53.0-76.0] vs 56.0 years [IQR, 37.0-64.0]), more likely to have comorbidities (35 [63.6%] vs 24 [39.3%]), and more likely to develop acute cardiac injury (19 [34.5%] vs 4 [6.6%]), acute heart failure (18 [32.7%] vs 3 [4.9%]), and ARDS (20 [36.4%] vs 0 [0%]). During hospitalization, the prevalence of new onset hypertension was significantly higher in severe patients (55.2% vs 19.0%) than in non-severe ones.
In this single-centered, retrospective, observational study, we found that the infection of SARS-CoV-2 was more likely to occur in middle and aged population with cardiovascular comorbidities. Cardiovascular complications, including new onset hypertension and heart injury were common in severe patients with COVID-19. More detailed researches in cardiovascular involvement in COVID-19 are urgently needed to further understand the disease.
一种由 2019 年新型冠状病毒（SARS-CoV-2）引起的急性呼吸道疾病，现称为 2019 年冠状病毒病（COVID-19），已成为全球大流行。患有心血管疾病的老年人群更容易感染 SARS-CoV-2，导致更严重的后果和更高的病死率。同时，心血管疾病在中老年人中发病率较高。然而，尽管对 COVID-19 进行了多项研究，但与 COVID-19 相关的心血管影响仍在很大程度上尚不清楚。因此，非常需要对 COVID-19 患者的心血管影响进行专门分析。
本研究为单中心、回顾性、观察性研究，共纳入 2020 年 1 月 20 日至 3 月 8 日期间入住中国中部战区总医院（武汉）的 116 例实验室确诊 COVID-19 患者。从电子病历中收集患者的人口统计学数据、合并症、临床症状和体征、实验室检查、胸部计算机断层扫描、治疗措施和转归数据。比较非重症组和重症组之间的数据。
116 例住院 COVID-19 患者的中位年龄为 58.5 岁（IQR，47.0-69.0），36 例（31.0%）为女性。最常见的合并症为高血压（45 例[38.8%]）、糖尿病（19 例[16.4%]）和冠心病（17 例[14.7%]）。常见症状包括发热（99 例[85.3%]）、干咳（61 例[52.6%]）、乏力（60 例[51.7%]）、呼吸困难（52 例[44.8%]）、食欲不振（50 例[43.1%]）和胸部不适（50 例[43.1%]）。胸部计算机断层扫描的典型影像学表现为局部或双侧斑片状阴影。66 例患者（56.9%）出现淋巴细胞减少（淋巴细胞计数 1.0×10/L [IQR，0.7-1.3]），69 例患者（59.5%）乳酸脱氢酶升高（245.5 U/L [IQR，194.3-319.8]）。24 例（20.7%）患者出现低钾血症。与非重症组相比，重症组年龄更大（64.0 岁 [IQR，53.0-76.0] vs 56.0 岁 [IQR，37.0-64.0]），更易合并症（35 例[63.6%] vs 24 例[39.3%]），更易发生急性心脏损伤（19 例[34.5%] vs 4 例[6.6%]）、急性心力衰竭（18 例[32.7%] vs 3 例[4.9%]）和急性呼吸窘迫综合征（20 例[36.4%] vs 0 例[0%]）。住院期间，重症组新发高血压的发生率明显高于非重症组（55.2% vs 19.0%）。
在这项单中心、回顾性、观察性研究中，我们发现 SARS-CoV-2 的感染更可能发生在患有心血管合并症的中年和老年人中。心血管并发症，包括新发高血压和心脏损伤，在 COVID-19 重症患者中很常见。需要进一步详细研究 COVID-19 中的心血管受累情况，以进一步了解该疾病。
