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心房颤动是高危 COVID-19 患者死亡的预测因素:一项对 171 例患者的多中心研究。

Atrial Fibrillation as a Predictor of Mortality in High Risk COVID-19 Patients: A Multicentre Study of 171 Patients.

机构信息

Division of Cardiovascular Medicine, Ascension Macomb, Warren, MI, USA.

Division of Cardiology, West Virginia University, Morgantown, WV, USA.

出版信息

Heart Lung Circ. 2021 Aug;30(8):1151-1156. doi: 10.1016/j.hlc.2021.02.010. Epub 2021 Mar 6.

Abstract

PURPOSE

Certain patient demographics and biomarkers have been suggested to predict survival in patients infected with COVID-19. However, predictors of outcome in patients who are critically ill are unclear.

MATERIALS AND METHODS

We performed a multicentre analysis of 171 consecutive patients with confirmed COVID-19 who were admitted to the intensive care unit (ICU) between 1 March 2020 and 30 April 2020 and were followed until 23 May 2020. Demographic data, past medical history, laboratory values, echocardiographic and telemetry data were analysed. Patient status was classified as either alive or deceased at hospital discharge or the end of follow-up period.

RESULTS

Mean patient age was 66±13 and 57% were male. Mortality rate of this ICU cohort at the end of follow-up was 46.2%. A multivariable logistic regression analysis identified the presence or history of atrial fibrillation (Odds Ratio 4.8, p=0.004) as a significant cardiovascular attribute that contributed to increased mortality.

CONCLUSION

Mortality of critically ill COVID-19 patients is high. This study suggests a relationship between atrial fibrillation and increased mortality from COVID-19. Early aggressive treatment patients with high risk characteristics, such as atrial fibrillation could improve clinical outcome.

摘要

目的

某些患者人口统计学特征和生物标志物被认为可以预测 COVID-19 感染患者的生存率。然而,对于重症患者的预后预测因素尚不清楚。

材料与方法

我们对 2020 年 3 月 1 日至 4 月 30 日期间入住重症监护病房(ICU)的 171 例连续确诊 COVID-19 患者进行了多中心分析,并随访至 2020 年 5 月 23 日。分析了人口统计学数据、既往病史、实验室值、超声心动图和遥测数据。患者状态在出院或随访期末分为存活或死亡。

结果

患者平均年龄为 66±13 岁,57%为男性。随访期末,该 ICU 队列的死亡率为 46.2%。多变量逻辑回归分析确定房颤的存在或病史(优势比 4.8,p=0.004)是导致死亡率增加的重要心血管特征。

结论

重症 COVID-19 患者的死亡率很高。本研究提示房颤与 COVID-19 死亡率增加之间存在关联。早期积极治疗具有高风险特征的患者,如房颤,可能改善临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7da/7936539/31d9c684426a/gr1_lrg.jpg

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