心率变异性和肾上腺大小为住院 COVID-19 患者心源性猝死提供线索。
Heart rate variability and adrenal size provide clues to sudden cardiac death in hospitalized COVID-19 patients.
机构信息
Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, United States of America.
Program for Hospital and Intensive Care Informatics, Departments of Neurology and Biomedical Informatics, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, United States of America.
出版信息
J Crit Care. 2022 Oct;71:154114. doi: 10.1016/j.jcrc.2022.154114. Epub 2022 Jul 18.
PURPOSE
To examine the association between a measure of heart rate variability and sudden cardiac death (SCD) in COVID-19 patients.
METHODS
Patients with SARS-COV-2 infection admitted to Columbia University Irving Medical Center who died between 4/25/2020 and 7/14/2020 and had an autopsy were examined for root mean square of successive differences (RMSSD), organ weights, and evidence of SCD.
RESULTS
Thirty COVID-19 patients were included and 12 had SCD. The RMSSD over 7 days without vs with SCD was median 0.0129 (IQR 0.0074-0.026) versus 0.0098 (IQR 0.0056-0.0197), p < 0.0001. The total adjusted adrenal weight of the non-SCD group was 0.40 g/kg (IQR 0.35-0.55) versus 0.25 g/kg (IQR 0.21-0.31) in the SCD group, p = 0.0007.
CONCLUSIONS
Hospitalized patients with COVID-19 who experienced SCD had lower parasympathetic activity (RMSSD) and smaller sized adrenal glands. Further research is required to replicate these findings.
目的
探讨心率变异性指标与 COVID-19 患者心源性猝死（SCD）的相关性。
方法
选取 2020 年 4 月 25 日至 7 月 14 日期间在哥伦比亚大学欧文医学中心因 SARS-CoV-2 感染住院并死亡且接受尸检的患者，评估其连续差异均方根（RMSSD）、器官重量和 SCD 证据。
结果
共纳入 30 例 COVID-19 患者，其中 12 例发生 SCD。无 SCD 组与 SCD 组 7 天 RMSSD 中位数分别为 0.0129（IQR，0.0074-0.026）和 0.0098（IQR，0.0056-0.0197），p<0.0001。非 SCD 组的总肾上腺重量为 0.40 g/kg（IQR，0.35-0.55），SCD 组为 0.25 g/kg（IQR，0.21-0.31），p=0.0007。
结论
COVID-19 住院患者发生 SCD 时副交感神经活性（RMSSD）降低，肾上腺较小。需要进一步研究来复制这些发现。
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