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疑似心血管疾病的成人长期新冠病毒感染表现患者的评估:单中心经验

Assessment of Adult Patients with Long COVID Manifestations Suspected as Cardiovascular: A Single-Center Experience.

作者信息

Shechter Alon, Yelin Dana, Margalit Ili, Abitbol Merry, Morelli Olga, Hamdan Ashraf, Vaturi Mordehay, Eisen Alon, Sagie Alex, Kornowski Ran, Shapira Yaron

机构信息

Department of Cardiology, Rabin Medical Center, Petach Tikva 4941492, Israel.

Faculty of Medicine, Tel Aviv University, Tel Aviv 6910203, Israel.

出版信息

J Clin Med. 2022 Oct 18;11(20):6123. doi: 10.3390/jcm11206123.

Abstract

: Persistent symptoms affect a subset of coronavirus disease 2019 (COVID-19) survivors. Some of these may be cardiovascular (CV)-related. : To assess the burden of objective CV morbidity among, and to explore the short-term course experienced by, COVID-19 patients with post-infectious symptomatology suspected as CV. : This was a single-center, retrospective analysis of consecutive adult patients with new-onset symptoms believed to be CV following recovery from COVID-19, who had been assessed at a dedicated 'Cardio'-COVID clinic between June 2020 and June 2021. All participants were followed for 1 year for symptomatic course and the occurrence of new CV diagnoses and major adverse cardiovascular events (MACE). : A total of 96 patients (median age 54 (IQR, 44-64) years, 52 (54%) females) were included in the final analysis. Initial visits occurred within a median of 142 days after the diagnosis of acute COVID. Nearly all (99%) patients experienced a symptomatic acute illness, which was graded as severe in 26 (27%) cases according to the National Institutes of Health (NIH) criteria. Long-COVID symptoms included mainly dyspnea and fatigue. While the initial work-up was mostly normal, 45% of the 11 cardiac magnetic resonance studies performed revealed pathologies. New CV diagnoses were made in nine (9%) patients and mainly included myocarditis that later resolved. An abnormal spirometry was the only variable associated with these. No MACE were recorded. Fifty-two (54%) participants felt that their symptoms improved. No association was found between CV morbidity and symptomatic course. : In our experience, long-COVID symptoms of presumed CV origin signified actual CV disease in a minority of patients who, irrespective of the final diagnosis, faced a fair 1-year prognosis.

摘要

持续性症状影响一部分2019冠状病毒病(COVID-19)幸存者。其中一些可能与心血管(CV)相关。

为评估疑似CV的感染后症状的COVID-19患者中客观CV发病率的负担,并探索其经历的短期病程。

这是一项单中心回顾性分析,研究对象为2020年6月至2021年6月期间在专门的“心脏”-COVID诊所接受评估的、从COVID-19康复后出现新发症状且被认为与CV相关的成年连续患者。所有参与者均随访1年,观察症状病程以及新的CV诊断和主要不良心血管事件(MACE)的发生情况。

最终分析纳入了96例患者(中位年龄54岁(四分位间距,44 - 64岁),52例(54%)为女性)。初次就诊发生在急性COVID诊断后的中位142天内。几乎所有(99%)患者都经历了有症状的急性疾病,根据美国国立卫生研究院(NIH)标准,其中26例(27%)为重症。长期COVID症状主要包括呼吸困难和疲劳。虽然初始检查大多正常,但11例心脏磁共振检查中有45%显示有病变。9例(9%)患者有新的CV诊断,主要包括后来缓解的心肌炎。异常肺功能检查是唯一与之相关的变量。未记录到MACE。52例(54%)参与者感觉症状有所改善。未发现CV发病率与症状病程之间存在关联。

根据我们的经验,推测起源于CV的长期COVID症状在少数患者中意味着实际的CV疾病,这些患者无论最终诊断如何,1年预后都尚可。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f098/9605399/bc47c66c6c2e/jcm-11-06123-g001.jpg

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