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老年 2019 冠状病毒病(COVID-19)患者合并心血管疾病和/或心血管疾病危险因素的临床及生物标志物特征和预后。

Clinical and Biomarker Profiles and Prognosis of Elderly Patients With Coronavirus Disease 2019 (COVID-19) With Cardiovascular Diseases and/or Risk Factors.

机构信息

Department of Cardiovascular Medicine, Toho University Graduate School of Medicine.

Department of Cardiology, Kameda Medical Center.

出版信息

Circ J. 2021 May 25;85(6):921-928. doi: 10.1253/circj.CJ-21-0160. Epub 2021 Apr 29.

DOI:10.1253/circj.CJ-21-0160
PMID:33952834
Abstract

BACKGROUND

This study investigated the effects of age on the outcomes of coronavirus disease 2019 (COVID-19) and on cardiac biomarker profiles, especially in patients with cardiovascular diseases and/or risk factors (CVDRF).

METHODS AND RESULTS

A nationwide multicenter retrospective study included 1,518 patients with COVID-19. Of these patients, 693 with underlying CVDRF were analyzed; patients were divided into age groups (<55, 55-64, 65-79, and ≥80 years) and in-hospital mortality and age-specific clinical and cardiac biomarker profiles on admission evaluated. Overall, the mean age of patients was 68 years, 449 (64.8%) were male, and 693 (45.7%) had underlying CVDRF. Elderly (≥80 years) patients had a significantly higher risk of in-hospital mortality regardless of concomitant CVDRF than younger patients (P<0.001). Typical characteristics related to COVID-19, including symptoms and abnormal findings on baseline chest X-ray and computed tomography scans, were significantly less prevalent in the elderly group than in the younger groups. However, a significantly (P<0.001) higher proportion of elderly patients were positive for cardiac troponin (cTn), and B-type natriuretic peptide (BNP) and N-terminal pro BNP (NT-proBNP) levels on admission were significantly higher among elderly than younger patients (P<0.001 and P=0.001, respectively).

CONCLUSIONS

Elderly patients with COVID-19 had a higher risk of mortality during the hospital course, regardless of their history of CVDRF, were more likely to be cTn positive, and had significantly higher BNP/NT-proBNP levels than younger patients.

摘要

背景

本研究调查了年龄对 2019 年冠状病毒病(COVID-19)结局以及心脏生物标志物谱的影响,尤其是在患有心血管疾病和/或风险因素(CVDRF)的患者中。

方法和结果

一项全国性多中心回顾性研究纳入了 1518 例 COVID-19 患者。其中分析了 693 例有潜在 CVDRF 的患者;患者被分为年龄组(<55 岁、55-64 岁、65-79 岁和≥80 岁),并评估了入院时的死亡率和年龄特异性临床及心脏生物标志物谱。总体而言,患者的平均年龄为 68 岁,449 例(64.8%)为男性,693 例(45.7%)有潜在 CVDRF。无论是否合并 CVDRF,高龄(≥80 岁)患者的院内死亡率显著高于年轻患者(P<0.001)。与年轻患者相比,老年患者与 COVID-19 相关的典型特征,包括症状和基线胸部 X 线和计算机断层扫描异常,明显较少见。然而,老年患者心脏肌钙蛋白(cTn)和 B 型利钠肽(BNP)和 N 末端 pro BNP(NT-proBNP)阳性的比例显著更高(P<0.001 和 P=0.001)。

结论

COVID-19 老年患者无论是否有 CVDRF 病史,住院期间死亡率更高,更有可能 cTn 阳性,BNP/NT-proBNP 水平显著高于年轻患者。

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