Department of Cardiology and Angiology, University of Tübingen, Otfried-Müller-Str.10, 72076, Tübingen, Germany.
BMC Infect Dis. 2022 Jun 13;22(1):539. doi: 10.1186/s12879-022-07488-y.
Acute myocardial injury is associated with poor prognosis in respiratory tract infections. We aimed to highlight the differences in prevalence of myocardial injury and its impact on prognosis in patients with COVID-19 compared to those with seasonal influenza.
This was a single-center prospective cohort study with a historical control group. 300 age-/sex-matched SARS-CoV-2 and seasonal influenza positive patients were enrolled. Myocardial injury was assessed by electrocardiogram (ECG), transthoracic echocardiography and biomarkers including high-sensitivity troponin-I. All patients were followed-up for 30 days after enrollment for all-cause mortalitiy, admission to the intensive care unit (ICU) and mechanical ventilation.
Right ventricular distress was more common in COVID-19 whereas pathological ECG findings and impaired left ventricular function were more prevalent among influenza patients. COVID-19 patients suffered from a higher percentage of hypertension and dyslipidaemia. Contrary to COVID-19, pericardial effusion at admission was associated with poor outcome in the influenza group. Severe course of disease and respiratory failure resulted in significantly higher rates of ICU treatment and mechanical ventilation in COVID-19 patients. Although distribution of myocardial injury was similar, significantly fewer cardiac catheterizations were performed in COVID-19 patients. However, number of cardiac catheterizations was low in both groups. Finally, 30-day mortality was significantly higher in COVID-19 compared to influenza patients.
In adults requiring hospitalization due to COVID-19 or seasonal influenza, cardiovascular risk factors and signs of myocardial distress differ significantly. Furthermore, cardiovascular comorbidities may impair prognosis in COVID-19 patients to a higher degree than in their influenza counterparts.
急性心肌损伤与呼吸道感染的不良预后相关。我们旨在强调 COVID-19 患者与季节性流感患者相比，心肌损伤的患病率差异及其对预后的影响。
这是一项单中心前瞻性队列研究，设有历史对照组。纳入了 300 名年龄和性别匹配的 SARS-CoV-2 和季节性流感阳性患者。通过心电图（ECG）、经胸超声心动图和包括高敏肌钙蛋白 I 在内的生物标志物评估心肌损伤。所有患者在入组后 30 天内进行随访，以评估全因死亡率、入住重症监护病房（ICU）和机械通气的情况。
右心室窘迫在 COVID-19 中更为常见，而流感患者中更常见的是病理性心电图表现和左心室功能障碍。COVID-19 患者中高血压和血脂异常的比例更高。与 COVID-19 相反，入院时的心包积液与流感组的不良预后相关。严重的疾病过程和呼吸衰竭导致 COVID-19 患者 ICU 治疗和机械通气的比例显著升高。尽管心肌损伤的分布相似，但 COVID-19 患者的心脏导管检查明显较少。然而，两组的心脏导管检查数量都较低。最后，COVID-19 患者的 30 天死亡率明显高于流感患者。
在因 COVID-19 或季节性流感而需要住院治疗的成年人中，心血管危险因素和心肌窘迫的迹象存在显著差异。此外，心血管合并症可能会对 COVID-19 患者的预后产生比流感患者更大的影响。
