Unidad de Cardiopatías Familiares, Instituto de Investigación Biomédica de A Coruña (INIBIC), Hospital Universitario de A Coruña (HUAC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), A Coruña, Spain.
Hospital Universitario Virgen de Arrixaca, Murcia. Spain; European Reference Networks for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart), Amsterdam, The Netherlands.
Med Clin (Barc). 2023 Dec 7;161(11):476-482. doi: 10.1016/j.medcli.2023.06.025. Epub 2023 Sep 6.
Descriptions on impact of SARS-CoV-2 infection in patients with cardiac amyloidosis (CA) are lacking. Our aim was to describe the prognosis of those patients.
Retrospective observational study of unvaccinated patients with CA who developed SARS-CoV-2 infection enrolled in eleven centres (March 2020 to May 2021). Descriptive analysis of basal characteristics, hospitalization, mortality, and severe clinical course was performed. Comparisons to a population-based control group were made.
Forty-one patients were identified. Most patients had wild-type transthyretin CA (61%) and were on NYHA Class II-III (80.5%). CA patients were commonly hospitalized (73.2%) and those were more symptomatic than outpatients (p=0.035). The 24.4% of CA patients died as consequence of SARS-CoV-2 infection. Patients with CA had an increased risk of hospitalization [OR 6.23 (3.05-12.74), p<0.001] and mortality [OR 2.18 (1.01-4.68), p=0.047] when compared to control population after adjustment by age and sex. After a medium follow-time of 311 days, 41.5% of the CA cohort died.
SARS-CoV-2 infection is associated with high mortality and hospitalization rates in patients with CA, which exceed that expected by their sex and advanced age.
关于 SARS-CoV-2 感染对心脏淀粉样变（CA）患者的影响的描述尚缺乏。我们的目的是描述这些患者的预后。
这是一项回顾性观察研究，纳入了 11 个中心的未接种疫苗且发生 SARS-CoV-2 感染的 CA 患者（2020 年 3 月至 2021 年 5 月）。对基本特征、住院情况、死亡率和严重临床病程进行描述性分析，并与基于人群的对照组进行比较。
共纳入 41 例患者。大多数患者为野生型转甲状腺素蛋白 CA（61%），NYHA 心功能分级为 II-III 级（80.5%）。CA 患者常住院治疗（73.2%），且住院患者的症状比门诊患者更严重（p=0.035）。24.4%的 CA 患者因 SARS-CoV-2 感染而死亡。CA 患者在调整年龄和性别后，与对照组相比，住院[OR 6.23（3.05-12.74），p<0.001]和死亡[OR 2.18（1.01-4.68），p=0.047]的风险增加。在平均随访 311 天之后，CA 队列中有 41.5%的患者死亡。
SARS-CoV-2 感染与 CA 患者的高死亡率和住院率相关，其死亡率和住院率超过了按性别和年龄校正后的预期值。
