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高敏心肌肌钙蛋白评估的急性心肌损伤预测 COVID-19 感染住院患者的严重结局和死亡。

Acute Myocardial Injury Assessed by High-Sensitive Cardiac Troponin Predicting Severe Outcomes and Death in Hospitalized Patients with COVID-19 Infection.

机构信息

Department of Cardiology, 470522Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, Morocco.

Department of Anesthesia and Intensive Care, 470522Mohamed VI University Hospital Center, Mohamed I University, Oujda, Morocco.

出版信息

Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221090227. doi: 10.1177/10760296221090227.

Abstract

BACKGROUND

Cardiac injury has been linked to a poor prognosis during COVID-19 disease. Nevertheless, the risk factors associated are yet to be thoroughly investigated.

OBJECTIVES

We sought to compare demographical characteristics and in-hospital outcomes in patients infected by the SARS-CoV-2 with and without cardiac injury, to further investigate the prevalence of acute cardiac injury as well as its impact on their outcomes in COVID-19-patients.

METHODS

We included in a retrospective analysis, all COVID-19 patients admitted between October first and December first, 2020, at the University Hospital Center of Oujda (Morocco) who underwent a troponin assay which was systematically measured on admission. The study population was divided into two groups: cardiac-injured patients and those without cardiac injury. Clinical, biological data and in-hospital outcomes were compared between the two groups.

RESULTS

298 confirmed COVID-19 cases were included. Our study found that compared to non-cardiac-injured, cardiac-injured patients are older, with higher possibilities of existing comorbidities including hypertension (68 [42.2%] vs 40 [29.2%], P = 0.02), diabetes (81 [50.3%] vs 53 [38.7%] P = 0.044), the need for mechanical ventilation, ICU admission and mortality. A Cox proportional hazards regression analysis shows a significantly increased risk of death among cardiac-injured COVID-19-patients as compared to non-cardiac injured. (HR, 1.620 [CI 95%: 2.562-1.024]).

CONCLUSION

Our retrospective cohort found that old age, comorbidities, a previous history of CAD, were significantly associated with acute cardiac injury. COVID-19 patients with acute cardiac injury are at a higher risk of ICU admission, and death.

摘要

背景

心脏损伤与 COVID-19 疾病期间的不良预后有关。然而,相关的危险因素仍有待深入研究。

目的

我们旨在比较感染 SARS-CoV-2 且伴有和不伴有心脏损伤的患者的人口统计学特征和住院结局,进一步调查急性心脏损伤的发生率及其对 COVID-19 患者结局的影响。

方法

我们回顾性分析了 2020 年 10 月 1 日至 12 月 1 日期间在摩洛哥乌季达大学医院中心住院的所有 COVID-19 患者,所有患者均接受了肌钙蛋白检测,且该检测在入院时进行了系统测量。研究人群分为两组:心脏损伤患者和无心脏损伤患者。比较两组之间的临床、生物学数据和住院结局。

结果

共纳入 298 例确诊 COVID-19 病例。与无心脏损伤患者相比,心脏损伤患者年龄更大,存在合并症的可能性更高,包括高血压(68 [42.2%] 例 vs 40 [29.2%] 例,P=0.02)、糖尿病(81 [50.3%] 例 vs 53 [38.7%] 例,P=0.044)、需要机械通气、入住 ICU 和死亡。Cox 比例风险回归分析显示,与无心脏损伤 COVID-19 患者相比,心脏损伤 COVID-19 患者死亡风险显著增加(HR,1.620 [95%CI:2.562-1.024])。

结论

我们的回顾性队列研究发现,年龄较大、合并症、既往 CAD 病史与急性心脏损伤显著相关。患有急性心脏损伤的 COVID-19 患者更有可能入住 ICU 和死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/020f/8980418/a68fd46a1c48/10.1177_10760296221090227-fig1.jpg

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