Jameie Mana, Safarian Nematabad Mohammad, Mansouri Pejman, Jalali Arash, Aghajani Faezeh, Lotfi-Tokaldany Masoumeh, Aghajani Hassan
Tehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Cardiac Primary Prevention Research Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
J Tehran Heart Cent. 2023 Apr;18(2):136-141. doi: 10.18502/jthc.v18i2.13324.
Studies have shown a decline in the admission rates of various diseases during the COVID-19 pandemic. Prosthetic valve thrombosis (PVT) is a rare condition followed by surgical or transcatheter valvular interventions. Considering the lack of data on hospitalization rates due to PVT during the pandemic, this study evaluated the implications of the COVID-19 pandemic on PVT admissions and characteristics in a tertiary referral center.
Data from all the consecutive patients hospitalized due to PVT between February 2020 and February 2021 (the first year of the pandemic) were collected from medical records and compared clinically with the corresponding time before the pandemic (February 2019 through February 2020). Variables of interest included the number of hospitalization, patient and valve characteristics, diagnostic and management strategies, and in-hospital events.
Forty patients (32.5% male, age: 54.0 [46.5-62.0 y] comprised the study population. We observed a considerable decline in hospitalization rates during the pandemic, from 31 to 9 patients. Admitted patients were 8 years younger, had a higher proportion of the New York Heart Association functional class III or IV symptoms (44.4% vs 22.6%), were more often treated with fibrinolysis (33.3% vs 22.6%) or surgical approaches (33.3% vs 22.6%), and were discharged 6 days sooner.
We described a reduction in PVT hospitalization. Patients presented with a higher proportion of severe dyspnea and had increased treatment with fibrinolysis/surgical approaches. These observations highlight the necessity of the active surveillance of patients with prosthetic valves by caregivers for timely diagnosis and appropriate management during the pandemic.
研究表明,在新冠疫情期间,各种疾病的入院率有所下降。人工瓣膜血栓形成(PVT)是一种罕见的疾病,常发生于外科或经导管瓣膜介入治疗之后。鉴于疫情期间缺乏因PVT导致的住院率数据,本研究评估了新冠疫情对一家三级转诊中心PVT入院情况及特征的影响。
收集了2020年2月至2021年2月(疫情第一年)期间因PVT连续住院的所有患者的数据,并与疫情前相应时间段(2019年2月至2020年2月)的临床数据进行比较。感兴趣的变量包括住院人数、患者和瓣膜特征、诊断和管理策略以及院内事件。
40名患者(男性占32.5%,年龄:54.0[46.5 - 62.0岁])构成了研究人群。我们观察到疫情期间住院率大幅下降,从31例降至9例。入院患者年龄小8岁,纽约心脏协会功能分级为III或IV级症状的比例更高(44.4%对22.6%),接受纤维蛋白溶解治疗(33.3%对22.6%)或手术治疗的频率更高(33.3%对22.6%),出院时间提前了6天。
我们描述了PVT住院率的降低。患者出现严重呼吸困难的比例更高,接受纤维蛋白溶解/手术治疗的情况增加。这些观察结果凸显了在疫情期间,医护人员对人工瓣膜患者进行积极监测以实现及时诊断和适当管理的必要性。