Yan Lijie, Wu Jintao, Fan Xianwei, Liu Jingjing, Zhang Leiming, Hu Juan, Li Xuejie, Su Yandong, Zhang Futao, Xu Xizheng, Chen Xiaosheng, Yang Haitao
Heart Center of Henan Provincial People's Hospital, Fuwai Central China Cardiovascular Hospital, Fuwai Central China Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Department of Cardiology, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
Front Med (Lausanne). 2023 Jul 27;10:1186200. doi: 10.3389/fmed.2023.1186200. eCollection 2023.
Complications, including arrhythmia, following severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection continue to be of concern. Omicron is the mainstream SARS-CoV-2 mutant circulating in mainland China. At present, there are few epidemiological studies concerning the relationship between arrhythmia and Omicron variant infection in mainland China.
To investigate the risk factors of arrhythmia in patients infected with the SARS-CoV-2 Omicron variant and the factors influencing prognosis.
Data from 192 Omicron infected patients with symptoms of arrhythmia (AH group) and 100 Omicron infected patients without arrhythmia (Control group) were collected. Patients in the AH group were divided into the good and poor prognosis groups, according to the follow-up results 4-6 weeks after infection. The general and clinical data between the AH and Control groups, and between the good and poor prognosis groups were compared. The variables with differences between the groups were included in the multivariate logistic regression analysis, and the quantitative variables were analyzed by receiver operating characteristic curve to obtain their cut-off values.
Compared with the control group, the body mass index (BMI), proportion of patients with a history of arrhythmia, proportion of antibiotics taken, heart rate, moderate disease severity, white blood cell (WBC) count, and the aspartate aminotransferase, creatine kinase (CK), CK isoenzyme (CK-MB), myoglobin (Mb), high-sensitive troponin I (hs-cTnI), lymphocyte ratio and high sensitivity C-reactive protein (hs-CRP) levels in the AH group were significantly higher ( < 0.05). In addition, obesity (BMI ≥24 kg/m), fast heart rate (≥100 times/min), moderate disease severity, and WBC, CK-MB and hs-cTnI levels were independent risk factors of arrhythmia for patients with Omicron infection ( < 0.05), and hs-CRP was a protective factor ( < 0.05). Compared with the good prognosis group, the age, proportion of patients with a history of arrhythmia, heart rate, proportion of moderate disease severity, and hs-CRP, CK, Mb and hs-cTnI levels were significantly higher in the poor prognosis group, while the proportion of vaccination was lower in the poor prognosis group ( < 0.05). Advanced age (≥65 years old), proportion of history of arrhythmia, moderate disease severity, vaccination, and hs-CRP, Mb and cTnI levels were independent factors for poor prognosis of patients with arrhythmia ( < 0.05).
The factors that affect arrhythmia and the prognosis of patients infected with Omicron include obesity, high heart rate, severity of the disease, age. history of arrhythmia, WBC, hs-CRP, and myocardial injury indexes, which could be used to evaluate and prevent arrhythmia complications in patients in the future.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染后的并发症，包括心律失常，仍然令人担忧。奥密克戎是在中国内地流行的主流SARS-CoV-2变异株。目前，中国内地关于心律失常与奥密克戎变异株感染之间关系的流行病学研究较少。
探讨感染SARS-CoV-2奥密克戎变异株患者发生心律失常的危险因素及影响预后的因素。
收集192例有心律失常症状的奥密克戎感染患者（AH组）和100例无心律失常的奥密克戎感染患者（对照组）的数据。根据感染后4-6周的随访结果，将AH组患者分为预后良好组和预后不良组。比较AH组与对照组之间以及预后良好组与预后不良组之间的一般和临床资料。将组间有差异的变量纳入多因素逻辑回归分析，并通过受试者工作特征曲线分析定量变量以获得其截断值。
与对照组相比，AH组的体重指数（BMI）、有心律失常病史患者的比例、服用抗生素的比例、心率、疾病严重程度为中度、白细胞（WBC）计数、以及天门冬氨酸氨基转移酶、肌酸激酶（CK）、CK同工酶（CK-MB）、肌红蛋白（Mb）、高敏肌钙蛋白I（hs-cTnI）、淋巴细胞比例和高敏C反应蛋白（hs-CRP）水平均显著更高（<0.05）。此外，肥胖（BMI≥24kg/m²）、心率快（≥100次/分钟）、疾病严重程度为中度以及WBC、CK-MB和hs-cTnI水平是奥密克戎感染患者发生心律失常的独立危险因素（<0.05），而hs-CRP是保护因素（<0.05）。与预后良好组相比，预后不良组的年龄、有心律失常病史患者的比例、心率、疾病严重程度为中度的比例以及hs-CRP、CK、Mb和hs-cTnI水平均显著更高，而预后不良组的疫苗接种比例更低（<0.05）。高龄（≥65岁）、心律失常病史比例、疾病严重程度为中度、疫苗接种情况以及hs-CRP、Mb和cTnI水平是心律失常患者预后不良的独立因素（<0.05）。
影响奥密克戎感染患者心律失常及预后的因素包括肥胖、心率快、疾病严重程度、年龄、心律失常病史、WBC、hs-CRP以及心肌损伤指标，这些因素未来可用于评估和预防患者的心律失常并发症。
