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感染冠状病毒时心肌损伤的意外演变:一例COVID-19病例报告。

The unexpected evolution of myocardial injury while infected with the coronavirus: A COVID-19 case report.

作者信息

Doran J T

机构信息

Jean Doran Biokineticist, Letterkenny, Derry and Strabane, Ireland and United Kingdom.

Director at Just Kinetics Preventive Health Care Provider, Ireland, United Kingdom and South Africa.

出版信息

S Afr J Sports Med. 2022 Jan 1;34(1):v34i1a11110. doi: 10.17159/2078-516X/2022/v34i1a11110. eCollection 2022.

DOI:10.17159/2078-516X/2022/v34i1a11110
PMID:36815909
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9924572/
Abstract

BACKGROUND

A novel virus breakout in December 2019, with diverse clinical manifestations, initially identified as infecting the respiratory system, has spread rapidly around the world, with adverse effects which have caused acute myocardial injury and chronic damage to the cardiovascular system in some individuals.

AIM

To present a clinical case with the manifestation of COVID-19 suspected to be either a mild case of either myocarditis or pericarditis. This case highlights a relatively atypical presentation of COVID-19 and the value of a coordinated approach to the unexpected sequences of patient recovery patterns that may require further specialist referral and intervention.

FINDINGS

A ribonucleic acid (RNA) viral infection was confirmed by a polymerase chain reaction with reverse transcription (RT-PCR) and the patient was diagnosed with coronavirus disease 2019 (COVID-19). The presenting symptoms failed to resolve and the patient was admitted to the accident and emergency (A&E) department. Upon the second visit to the A&E department at 27 days postinfection, an electrocardiograph (ECG) was conducted revealing T wave inversion.

IMPLICATIONS

A coordinated approach is needed to combat the infection, develop cardiac-protective strategies and direct supportive measures.

摘要

背景

2019年12月出现了一种新型病毒疫情,其临床表现多样,最初被确定为感染呼吸系统,已在全球迅速传播,在一些个体中造成了不良影响,导致急性心肌损伤和心血管系统的慢性损害。

目的

介绍一例疑似新型冠状病毒肺炎(COVID-19)表现为轻度心肌炎或心包炎的临床病例。该病例突出了COVID-19相对非典型的表现,以及对患者恢复模式中意外情况采取协调方法的价值,这可能需要进一步的专科转诊和干预。

发现

通过逆转录聚合酶链反应(RT-PCR)确认了核糖核酸(RNA)病毒感染,患者被诊断为2019冠状病毒病(COVID-19)。出现的症状未得到缓解,患者被收入急诊部。在感染后27天第二次就诊于急诊部时,进行了心电图(ECG)检查,显示T波倒置。

启示

需要采取协调一致的方法来对抗感染、制定心脏保护策略并指导支持性措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/175e/9924572/afa4811d8d27/2078-516X-34-v34i1a11110-g001b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/175e/9924572/b47617a52e2a/2078-516X-34-v34i1a11110-g001a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/175e/9924572/afa4811d8d27/2078-516X-34-v34i1a11110-g001b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/175e/9924572/b47617a52e2a/2078-516X-34-v34i1a11110-g001a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/175e/9924572/afa4811d8d27/2078-516X-34-v34i1a11110-g001b.jpg

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本文引用的文献

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Electrocardiography in Early Diagnosis of Cardiovascular Complications of COVID-19; a Systematic Literature Review.心电图在COVID-19心血管并发症早期诊断中的应用;系统文献综述
Arch Acad Emerg Med. 2020 Dec 17;9(1):e10. doi: 10.22037/aaem.v9i1.957. eCollection 2021.
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The effects of novel coronavirus (SARS-CoV-2) infection on cardiovascular diseases and cardiopulmonary injuries.
新型冠状病毒(SARS-CoV-2)感染对心血管疾病和心肺损伤的影响。
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Characterization of Myocardial Injury in Patients With COVID-19.新型冠状病毒肺炎患者心肌损伤特征。
J Am Coll Cardiol. 2020 Nov 3;76(18):2043-2055. doi: 10.1016/j.jacc.2020.08.069.
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A Review of Acute Myocardial Injury in Coronavirus Disease 2019.2019年冠状病毒病急性心肌损伤综述
Cureus. 2020 Jun 3;12(6):e8426. doi: 10.7759/cureus.8426.
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Clin Exp Pediatr. 2020 Apr;63(4):119-124. doi: 10.3345/cep.2020.00493. Epub 2020 Apr 2.