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心肌损伤作为新冠病毒感染康复者中长期随访的预后因素

Myocardial Injury as a Prognostic Factor in Mid- and Long-Term Follow-Up of COVID-19 Survivors.

作者信息

Izquierdo Andrea, Mojón Diana, Bardají Alfredo, Carrasquer Anna, Calvo-Fernández Alicia, Carreras-Mora José, Giralt Teresa, Pérez-Fernández Sílvia, Farré Núria, Soler Cristina, Solà-Richarte Clàudia, Cabero Paula, Vaquerizo Beatriz, Marrugat Jaume, Ribas Núria

机构信息

Cardiology Department, Hospital del Mar, Passeig Marítim de la Barceloneta 25-29, 08003 Barcelona, Spain.

Medicine Department, Autonomous University of Barcelona, Bellaterra, 08193 Barcelona, Spain.

出版信息

J Clin Med. 2021 Dec 16;10(24):5900. doi: 10.3390/jcm10245900.

Abstract

Myocardial injury, which is present in >20% of patients hospitalized for COVID-19, is associated with increased short-term mortality, but little is known about its mid- and long-term consequences. We evaluated the association between myocardial injury with one-year mortality and readmission in 172 COVID-19 patients discharged alive. Patients were grouped according to the presence or absence of myocardial injury (defined by hs-cTn levels) on admission and matched by age and sex. We report mortality and hospital readmission at one year after admission in all patients and echocardiographic, laboratory and clinical data at six months in a subset of 86 patients. Patients with myocardial injury had a higher prevalence of hypertension (73.3% vs. 50.0%, = 0.003), chronic kidney disease (10.5% vs. 2.35%, = 0.06) and chronic heart failure (9.3% vs. 1.16%, = 0.03) on admission. They also had higher mortality or hospital readmissions at one year (11.6% vs. 1.16%, = 0.01). Additionally, echocardiograms showed thicker walls in these patients (10 mm vs. 8 mm, = 0.002) but without functional disorder. Myocardial injury in COVID-19 survivors is associated with poor clinical prognosis at one year, independent of age and sex, but not with echocardiographic functional abnormalities at six months.

摘要

在因新冠肺炎住院的患者中,超过20%存在心肌损伤,这与短期死亡率增加相关,但对其中长期后果知之甚少。我们评估了172例存活出院的新冠肺炎患者中心肌损伤与一年死亡率及再入院之间的关联。根据入院时是否存在心肌损伤(由高敏肌钙蛋白水平定义)对患者进行分组,并按年龄和性别进行匹配。我们报告了所有患者入院一年后的死亡率和再入院情况,以及86例患者亚组在六个月时的超声心动图、实验室和临床数据。心肌损伤患者入院时高血压(73.3%对50.0%,P = 0.003)、慢性肾脏病(10.5%对2.35%,P = 0.06)和慢性心力衰竭(9.3%对1.16%,P = 0.03)的患病率更高。他们在一年时的死亡率或再入院率也更高(11.6%对1.16%,P = 0.01)。此外,超声心动图显示这些患者的心室壁更厚(10毫米对8毫米,P = 0.002),但无功能障碍。新冠肺炎幸存者的心肌损伤与一年时不良的临床预后相关,独立于年龄和性别,但与六个月时的超声心动图功能异常无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d1a/8708676/570bf50d0ed1/jcm-10-05900-g001.jpg

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