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COVID-19 相关的孕产妇死亡与肌钙蛋白 T 水平升高有关。

Maternal Death by COVID-19 Associated with Elevated Troponin T Levels.

机构信息

Clinical Research Branch, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, Mexico.

ABC Medical Center, Medical Association, Mexico City 05330, Mexico.

出版信息

Viruses. 2022 Jan 28;14(2):271. doi: 10.3390/v14020271.

Abstract

UNLABELLED

Cardiomyocyte injury and troponin T elevation has been reported within COVID-19 patients and are associated with a worse prognosis. Limited data report this association among COVID-19 pregnant patients.

OBJECTIVE

We aimed to analyze the association between troponin T levels in severe COVID-19 pregnant women and risk of viral sepsis, intensive care unit (ICU) admission, or maternal death.

METHODS

We performed a prospective cohort of all obstetrics emergency admissions from a Mexican National Institute. All pregnant women diagnosed by reverse transcription-polymerase chain reaction (RT-qPCR) for SARS-CoV-2 infection between October 2020 and May 2021 were included. Clinical data were collected, and routine blood samples were obtained at hospital admission. Seric troponin T was measured at admission.

RESULTS

From 87 included patients, 31 (35.63%) had severe COVID-19 pneumonia, and 6 (6.89%) maternal deaths. ROC showed a significant relationship between troponin T and maternal death (AUC 0.979, CI 0.500-1.000). At a cutoff point of 7 ng/mL the detection rate for severe pneumonia was 83.3% (95%CI: 0.500-0.100) at 10% false-positive rate.

CONCLUSION

COVID-19 pregnant women with elevated levels of troponin T present a higher risk of death and severe pneumonia.

摘要

未注明

已有报道称,COVID-19 患者存在心肌细胞损伤和肌钙蛋白 T 升高的情况,且与预后不良相关。但 COVID-19 孕妇中有关该关联的有限数据。

目的

我们旨在分析严重 COVID-19 孕妇中肌钙蛋白 T 水平与病毒败血症、重症监护病房(ICU)入院或孕产妇死亡风险之间的关系。

方法

我们对墨西哥国立研究所的所有产科急诊入院进行了前瞻性队列研究。所有在 2020 年 10 月至 2021 年 5 月期间通过逆转录-聚合酶链反应(RT-qPCR)诊断为 SARS-CoV-2 感染的孕妇均被纳入研究。收集临床数据,并在入院时采集常规血样。入院时测量血清肌钙蛋白 T。

结果

在 87 例纳入的患者中,31 例(35.63%)患有严重 COVID-19 肺炎,6 例(6.89%)孕产妇死亡。ROC 显示肌钙蛋白 T 与孕产妇死亡之间存在显著关系(AUC 0.979,CI 0.500-1.000)。在截断值为 7ng/mL 时,在 10%的假阳性率下,严重肺炎的检出率为 83.3%(95%CI:0.500-0.100)。

结论

肌钙蛋白 T 水平升高的 COVID-19 孕妇死亡和严重肺炎的风险更高。

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