SARS-CoV-2 感染：急性冠状动脉综合征的诱发因素。
SARS-CoV-2 infection: A predisposing factor for acute coronary syndrome.
机构信息
Servicio de Cardiología, Hospital Universitario Infanta Leonor, Madrid, España.
Servicio de Cardiología, Hospital Universitario Infanta Leonor, Madrid, España.
出版信息
Med Clin (Barc). 2021 Aug 13;157(3):114-117. doi: 10.1016/j.medcli.2021.01.004. Epub 2021 Jan 28.
INTRODUCTION
Several case series of ACS have been reported in COVID 19 patients. We aim to study its incidence, characteristics, and three-month prognosis. To put this incidence in perspective we compared it with the incidence of in-hospital ACS during the same period of 2019.
METHODS
Observational multicenter cohort study of 3,108 COVID-19 patients admitted to two hospitals in Madrid between March 1st and May 15th, 2020. Ten patients suffered an ACS while being hospitalized for COVID 19 and were followed for three months. The ACS incidence in hospitalized patients during the same period of 2019 was also studied.
RESULTS
The incidence of ACS in COVID-19 patients was 3.31 ‰, significantly higher than in the 2019 period, 1.01 ‰ (p = 0.013). COVID-19 patients that suffered and ACS frequently had a severe infection, presented with STEMI (80%), and had multivessel disease (67%). Mortality rate (30%) and hospital readmissions at three months (20%) were very high.
CONCLUSIONS
Severe COVID-19 patients develop ACS more frequently than expected. Although the overall incidence was low, it carried a poor immediate and three-month prognosis.
引言
已有多项关于 COVID-19 患者合并急性冠脉综合征（ACS）的病例系列报道。我们旨在研究 COVID-19 患者 ACS 的发生率、特征和三个月预后。为了更清楚地了解这一发病率，我们将其与 2019 年同期住院期间 ACS 的发生率进行了比较。
方法
这是一项观察性多中心队列研究，纳入了 2020 年 3 月 1 日至 5 月 15 日期间在马德里两家医院住院的 3108 例 COVID-19 患者。10 例患者在因 COVID-19 住院期间发生 ACS，并随访三个月。同时还研究了 2019 年同期住院患者 ACS 的发生率。
结果
COVID-19 患者 ACS 的发生率为 3.31‰，明显高于 2019 年的 1.01‰（p=0.013）。发生 ACS 的 COVID-19 患者常伴有严重感染，表现为 ST 段抬高型心肌梗死（80%），且多支血管病变（67%）。死亡率（30%）和三个月内再次住院率（20%）非常高。
结论
重症 COVID-19 患者发生 ACS 的频率高于预期。尽管总体发生率较低，但近期和三个月预后均较差。
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