Servicio de Cardiología, Hospital Universitario de Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain.
Servicio de Cardiología, Hospital Universitario de Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Facultad de Medicina, Universidad de Salamanca, Salamanca, Spain.
Rev Esp Cardiol (Engl Ed). 2022 Sep;75(9):734-746. doi: 10.1016/j.rec.2021.11.001. Epub 2021 Nov 5.
The cardiac sequelae of SARS-CoV-2 infection are still poorly documented. We conducted a cross-sectional study in healthcare workers to report evidence of pericardial and myocardial involvement after SARS-CoV-2 infection.
We studied 139 healthcare workers with confirmed past SARS-CoV-2 infection. Participants underwent clinical assessment, electrocardiography, and laboratory tests, including immune cell profiling and cardiac magnetic resonance (CMR). Clinically suspected pericarditis was diagnosed when classic criteria were present and clinically suspected myocarditis was based on the combination of at least 2 CMR criteria.
Median age was 52 (41-57) years, 71.9% were women, and 16.5% were previously hospitalized for COVID-19 pneumonia. On examination (10.4 [9.3-11.0] weeks after infection-like symptoms), participants showed hemodynamic stability. Chest pain, dyspnea or palpitations were present in 41.7% participants, electrocardiographic abnormalities in 49.6%, NT-proBNP elevation in 7.9%, troponin in 0.7%, and CMR abnormalities in 60.4%. A total of 30.9% participants met criteria for either pericarditis and/or myocarditis: isolated pericarditis was diagnosed in 5.8%, myopericarditis in 7.9%, and isolated myocarditis in 17.3%. Most participants (73.2%) showed altered immune cell counts in blood, particularly decreased eosinophil (27.3%; P<.001) and increased cytotoxic T cell numbers (17.3%; P <.001). Clinically suspected pericarditis was associated (P <.005) with particularly elevated cytotoxic T cells and decreased eosinophil counts, while participants diagnosed with clinically suspected myopericarditis or myocarditis had lower (P <.05) neutrophil counts, natural killer-cells, and plasma cells.
Pericardial and myocardial involvement with clinical stability are frequent after SARS-CoV-2 infection and are associated with specific immune cell profiles.
SARS-CoV-2 感染的心脏后遗症仍记录不佳。我们在医护人员中进行了一项横断面研究，报告 SARS-CoV-2 感染后心包和心肌受累的证据。
我们研究了 139 名经证实的过去 SARS-CoV-2 感染的医护人员。参与者接受了临床评估、心电图和实验室检查，包括免疫细胞分析和心脏磁共振（CMR）。当存在典型标准时诊断为临床疑似心包炎，当存在至少 2 个 CMR 标准时诊断为临床疑似心肌炎。
中位年龄为 52（41-57）岁，71.9%为女性，16.5%因 COVID-19 肺炎住院。在检查时（感染症状后 10.4[9.3-11.0]周），参与者表现出血流动力学稳定。41.7%的参与者有胸痛、呼吸困难或心悸，49.6%的参与者心电图异常，7.9%的参与者 NT-proBNP 升高，0.7%的参与者肌钙蛋白升高，60.4%的参与者 CMR 异常。共有 30.9%的参与者符合心包炎和/或心肌炎的标准：诊断为单纯性心包炎 5.8%，心肌心包炎 7.9%，单纯性心肌炎 17.3%。大多数参与者（73.2%）的血液免疫细胞计数发生改变，特别是嗜酸性粒细胞减少（27.3%；P<.001）和细胞毒性 T 细胞数量增加（17.3%；P<.001）。临床疑似心包炎与特别高的细胞毒性 T 细胞和嗜酸性粒细胞计数降低有关（P<.005），而诊断为临床疑似心肌心包炎或心肌炎的患者中性粒细胞、自然杀伤细胞和浆细胞计数较低（P<.05）。
SARS-CoV-2 感染后常出现心包和心肌受累且具有临床稳定性，并与特定的免疫细胞谱相关。
Zotero 插件
