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医学病房中 COVID-19 住院患者的房间隔阻滞的预后作用。

The prognostic role of interatrial block among COVID-19 patients hospitalized in medicine wards.

机构信息

Division of Cardiology, Department of Translational Medical Sciences, Monaldi and Cotugno Hospital, University of Campania 'Luigi Vanvitelli', Naples, Italy.

Cardiology Department, Aosta Valley Health Authority, Aosta, Italy.

出版信息

Eur J Clin Invest. 2022 Aug;52(8):e13781. doi: 10.1111/eci.13781. Epub 2022 Apr 5.

Abstract

INTRODUCTION

Some abnormal electrocardiographic findings were independently associated with increased mortality in patients admitted for COVID-19; however, no studies have focussed on the prognosis impact of the interatrial block (IAB) in this clinical setting. The aim of our study was to assess the prevalence and clinical implications of IAB, both partial and advanced, in hospitalized COVID-19 patients.

MATERIALS

We retrospectively evaluated 300 consecutive COVID-19 patients (63.22 ± 15.16 years; 70% males) admitted to eight Italian Hospitals from February 2020 to April 2020 who underwent twelve lead electrocardiographic recording at admission. The study population has been dichotomized into two groups according to the evidence of IAB at admission, both partial and advanced. The differences in terms of ARDS in need of intubation, in-hospital mortality and thromboembolic events (a composite of myocardial infarction, stroke and transient ischaemic attack) have been evaluated.

RESULTS

The presence of IAB was noticed in 64 patients (21%). In the adjusted logistic regression model, the partial interatrial block was found to be an independent predictor of ARDS in need of intubation (HR: 1.92; p: .04) and in-hospital mortality (HR: 2.65; p: .02); moreover, the advanced interatrial block was an independent predictor of thrombotic events (HR: 7.14; p < .001).

CONCLUSIONS

Among COVID-19 patients hospitalized in medical wards, the presence of interatrial block is more frequent than in the general population and it might be useful as an early predictor for increased risk of incident thrombotic events, ARDS in need of intubation and in-hospital mortality.

摘要

简介

一些异常的心电图发现与 COVID-19 住院患者的死亡率增加独立相关;然而,尚无研究关注在这种临床环境下房间隔阻滞(IAB)对预后的影响。我们的研究旨在评估在住院 COVID-19 患者中,部分和完全性 IAB 的患病率和临床意义。

材料

我们回顾性评估了 2020 年 2 月至 4 月期间在意大利 8 家医院住院的 300 例连续 COVID-19 患者(63.22±15.16 岁;70%为男性),他们在入院时接受了 12 导联心电图记录。根据入院时存在部分和完全性 IAB 的证据,将研究人群分为两组。评估了需要插管的 ARDS、住院死亡率和血栓栓塞事件(心肌梗死、中风和短暂性脑缺血发作的综合事件)的差异。

结果

64 例患者(21%)存在 IAB。在调整后的逻辑回归模型中,部分性房间隔阻滞是需要插管的 ARDS(HR:1.92;p:.04)和住院死亡率(HR:2.65;p:.02)的独立预测因素;此外,完全性房间隔阻滞是血栓事件(HR:7.14;p<.001)的独立预测因素。

结论

在住院于内科病房的 COVID-19 患者中,房间隔阻滞的存在比一般人群更为常见,它可能是预测血栓事件、需要插管的 ARDS 和住院死亡率增加的有用指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7758/9111721/83e99dc5405f/ECI-52-0-g003.jpg

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