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新型冠状病毒感染患者的心房颤动。

Atrial fibrillation in patients with SARS-CoV-2 infection.

机构信息

Department of Cardiology. Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario Valladolid, Valladolid, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.

Department of Cardiology. Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario Valladolid, Valladolid, Spain.

出版信息

Med Clin (Barc). 2021 Jul 23;157(2):58-63. doi: 10.1016/j.medcli.2021.01.003. Epub 2021 Jan 28.

Abstract

INTRODUCTION AND OBJECTIVE

the SARS-CoV-2 infection ranges from asymptomatic to critical forms and several prognostic factors have been described. Atrial fibrillation (AF) is common in acute situations where it is linked with more complications and mortality. We aimed to evaluate the prognostic information of AF in this population.

METHODS

retrospective analysis of a cohort of 517 patients consecutively admitted in a tertiary hospital due to SARS-CoV-2 infection. We divided the patients in two groups according the development of AF and compared the main features of both groups. An univariable and multivariable analysis of mortality were also performed.

RESULTS

among 517 patients with SARS-CoV-2 infection admitted in a tertiary center, 54 (10.4%) developed AF. These patients are older (81.6 vs 66.5 years old, p<0.001) and present more hypertension (74% vs 47%, p<0.001), cardiomyopathy (9% vs 1%, p=0.002), previous heart failure admission (9% vs 0.4%, p<0.001), previous episodes of AF (83% vs 1%, p<0.001) and bigger left atrium (47.8 vs 39.9mm, p<0.001). AF COVID-19 patients present more acute respiratory failure (72% vs 40%, p<0.001) and higher in-hospital mortality (50% vs 22%, p<0.001). Predictors of AF development are age and previous AF. AF is not an independent predictor of in-hospital mortality. Predictors are age, creatinine>1.5mg/dL at admission, LDH>250UI/L at admission and acute respiratory failure.

CONCLUSION

Atrial fibrillation appears in 10% of hospitalized patients with SARS-CoV-2 infection. These patients present more comorbidities and two-fold increase in hospital mortality. Atrial fibrillation is not an independent prognostic factor.

摘要

引言和目的

SARS-CoV-2 感染的范围从无症状到危急,已经描述了多种预后因素。心房颤动(AF)在急性情况下很常见,与更多的并发症和死亡率有关。我们旨在评估该人群中 AF 的预后信息。

方法

回顾性分析了一家三级医院连续收治的 517 例 SARS-CoV-2 感染患者的队列。我们根据 AF 的发生将患者分为两组,并比较了两组的主要特征。还进行了单变量和多变量死亡率分析。

结果

在一家三级中心收治的 517 例 SARS-CoV-2 感染患者中,有 54 例(10.4%)发生了 AF。这些患者年龄更大(81.6 岁 vs 66.5 岁,p<0.001),且更易出现高血压(74% vs 47%,p<0.001)、心肌病(9% vs 1%,p=0.002)、心力衰竭入院(9% vs 0.4%,p<0.001)、既往 AF 发作(83% vs 1%,p<0.001)和更大的左心房(47.8 毫米 vs 39.9 毫米,p<0.001)。AF COVID-19 患者更易发生急性呼吸衰竭(72% vs 40%,p<0.001)和更高的院内死亡率(50% vs 22%,p<0.001)。AF 发生的预测因素是年龄和既往 AF。AF 不是院内死亡率的独立预测因素。预测因素是年龄、入院时肌酐>1.5mg/dL、入院时 LDH>250UI/L 和急性呼吸衰竭。

结论

在住院的 SARS-CoV-2 感染患者中,10%出现 AF。这些患者合并症更多,院内死亡率增加两倍。AF 不是独立的预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d84/7843022/903023565a01/gr1_lrg.jpg

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