Department of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Cardiovascular Diseases Research Institute, Tehran Heart Center, Tehran, Iran.
Medicine (Baltimore). 2022 Dec 16;101(50):e31935. doi: 10.1097/MD.0000000000031935.
Cardiovascular injuries induced by SARS CoV-2 have been reported repeatedly in various studies. Therefore, it is necessary to understand cardiac complications at a low cost, quickly. This study aimed to determine the relationship between cardiological parameters and polymerase chain reaction (PCR) in patients with coronavirus infection. : Patients who were admitted to the emergency department due to the ongoing pandemic, all patients with similar symptoms to coronavirus disease 2019 infection were initially admitted to the respiratory emergency room and underwent subsequent evaluations to confirm or rule out SARS-COV2 infection symptoms were assessed for eligibility. Patient were categorized into 2 groups 1. Positive PCR and negative PCR groups. Binary logistic regression was performed to assess the effect of several factors on the likelihood of developing positive troponin, reduced ejection fraction (EF), and Positive brain natriuretic peptide (BNP). Among 195 patients included, 115 (58.9%) had positive PCR. Patient in the positive PCR and negative PCR were 58.04 ± 18.03 and 59.19 ± 15.38 years of age, respectively. Patients in the "positive PCR" were significantly less likely to have chronic kidney disease (6.69% vs 17.5%, P value: .022), consume calcium channel blockers (6.69% vs 18.75%, P value:0.012). At the univariable level, positive PCR was significantly associated with fewer odds for positive BNP (OR:0.46, P = .019); nevertheless, the association was no longer significant after adjusting for confounders (adjusted OR:0.56, P = .158). Unadjusted positive PCR results were not found to have a significant association with positive troponin or reduced EF. Likewise, multivariable regression revealed no association between positive PCR and positive troponin (aOR:1.28, P = .529) and reduced EF (aOR:0.65, P = .369). PCR positivity did not result in positive troponin and BNP and did not appear to decrease EF. In other words, serial troponin and BNP checks and initial echocardiography in coronavirus disease 2019 respiratory emergencies do not make significant differences in diagnostic and therapeutic management and inpatient outcomes of patients with positive or negative PCR and are not specific findings. Evidence suggests some coronavirus-induced cardiac complications will be manifested in the long term.
在各种研究中反复报道了由 SARS CoV-2 引起的心血管损伤。因此，有必要以较低的成本快速了解心脏并发症。本研究旨在确定患有冠状病毒感染的患者中心血管参数与聚合酶链反应（PCR）之间的关系。
由于持续的大流行，因该病毒而入住急诊病房的患者，所有有类似 2019 年冠状病毒疾病感染症状的患者最初都被收入呼吸急救室，并进行后续评估以确认或排除 SARS-COV2 感染症状，评估其是否符合入选标准。患者被分为 2 组：1. PCR 阳性组和 PCR 阴性组。进行二项逻辑回归分析，以评估多种因素对肌钙蛋白阳性、射血分数降低（EF）和脑利钠肽（BNP）阳性的可能性的影响。在纳入的 195 名患者中，有 115 名（58.9%）PCR 阳性。PCR 阳性和 PCR 阴性组的年龄分别为 58.04±18.03 岁和 59.19±15.38 岁。PCR 阳性组的慢性肾脏病（6.69%比 17.5%，P 值：.022）和钙通道阻滞剂的使用率（6.69%比 18.75%，P 值：0.012）明显较低。在单变量水平上，PCR 阳性与较少的 BNP 阳性几率显著相关（OR：0.46，P=0.019）；然而，在调整混杂因素后，这种关联不再显著（调整后的 OR：0.56，P=0.158）。未发现未经调整的 PCR 阳性结果与肌钙蛋白阳性或 EF 降低有显著关联。同样，多变量回归显示，PCR 阳性与肌钙蛋白阳性（aOR：1.28，P=0.529）和 EF 降低（aOR：0.65，P=0.369）之间无关联。PCR 阳性并未导致肌钙蛋白和 BNP 阳性，也似乎未降低 EF。换句话说，在冠状病毒疾病 2019 呼吸道急症中，连续的肌钙蛋白和 BNP 检查以及初始超声心动图检查在诊断和治疗管理以及 PCR 阳性或阴性患者的住院结局方面没有显著差异，这些也不是特异性发现。证据表明，一些由冠状病毒引起的心脏并发症将在长期内表现出来。
