Division of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Division of Cardiology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Clin Infect Dis. 2023 Feb 8;76(3):e1385-e1391. doi: 10.1093/cid/ciac525.
Human babesiosis is a worldwide emerging tick-borne disease caused by intraerythrocytic protozoa. Most patients experience mild to moderate illness, but life-threatening complications can occur. Although cardiac complications are common, the full spectrum of cardiac disease and the frequency, risk factors, and outcomes in patients experiencing cardiac complications are unclear. Accordingly, we carried out a record review of cardiac complications among patients with babesiosis admitted to Yale-New Haven Hospital over the last decade to better characterize cardiac complications of babesiosis.
We reviewed the medical records of all adult patients with babesiosis admitted to Yale-New Haven Hospital from January 2011 to October 2021, confirmed by identification of Babesia parasites on thin blood smear and/or by polymerase chain reaction. The presence of Lyme disease and other tick-borne disease coinfections were recorded.
Of 163 enrolled patients, 32 (19.6%) had ≥1 cardiac complication during hospitalization. The most common cardiac complications were atrial fibrillation (9.4%), heart failure (8.6%), corrected QT interval prolongation (8.0%), and cardiac ischemia (6.8%). Neither cardiovascular disease risk factors nor preexisting cardiac conditions were significantly associated with the development of cardiac complications. The cardiac complication group had a greater prevalence of high-grade parasitemia (>10%) (P < .001), longer median length of both hospital (P < .001) and intensive care unit stay (P < .001), and a higher mortality rate (P = .02) than the group without cardiac complications.
Cardiac complications of acute babesiosis are common and occurred in approximately one-fifth of this inpatient sample. Further investigation is needed to elucidate the relationship between babesiosis severity and cardiac outcomes.
人类巴贝斯虫病是一种由红细胞内原生动物引起的全球性新兴蜱传疾病。大多数患者病情较轻至中度，但可能出现危及生命的并发症。尽管心脏并发症很常见，但心脏疾病的全貌以及发生心脏并发症患者的频率、危险因素和结局尚不清楚。因此，我们对过去十年间在耶鲁-纽黑文医院住院的巴贝斯虫病患者的心脏并发症进行了病历回顾，以更好地描述巴贝斯虫病的心脏并发症。
我们回顾了 2011 年 1 月至 2021 年 10 月期间在耶鲁-纽黑文医院住院的所有成人巴贝斯虫病患者的病历，这些患者通过薄血涂片鉴定巴贝斯虫寄生虫和/或聚合酶链反应确诊。记录莱姆病和其他蜱传疾病的合并感染情况。
在 163 名入组患者中，32 名（19.6%）在住院期间出现了≥1 种心脏并发症。最常见的心脏并发症是心房颤动（9.4%）、心力衰竭（8.6%）、校正 QT 间期延长（8.0%）和心肌缺血（6.8%）。心血管疾病危险因素或预先存在的心脏疾病与心脏并发症的发生均无显著相关性。心脏并发症组高等级寄生虫血症（>10%）的患病率更高（P<0.001），住院时间（P<0.001）和重症监护病房住院时间（P<0.001）中位数均更长，死亡率更高（P=0.02）。
急性巴贝斯虫病的心脏并发症很常见，在本住院患者样本中约占五分之一。需要进一步研究阐明巴贝斯虫病严重程度与心脏结局之间的关系。
