[新型冠状病毒肺炎患者中肌钙蛋白I所致心肌损伤相关的死亡率]

[Mortality associated with myocardial damage by troponin I in patients with COVID 19].

作者信息

Espriu-Romero Donovan Fernando, Hernández-González Martha Alicia, Solorio-Meza Sergio Eduardo

机构信息

Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No.1, Servicio de Cardiología. León, Guanajuato, México.

Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, División de Investigación. León, Guanajuato, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2023 Sep 18;61(Suppl 2):S155-S160.

PMID:38011615

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10766439/

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) can cause cardiac injury, probably associated with myocarditis and ischemia induced by the infection. Myocardial damage leads to the liberation of proinflammatory cytokines and to the activation of autoimmune adaptive mechanisms through molecular limitation.

OBJECTIVE

To assess mortality associated with myocardial damage in hospitalized patients with COVID-19 confirmed by troponin I measurement.

MATERIAL AND METHODS

Case-control study nested in a cohort of patients of a third-level hospital. Descriptive statistics were used to characterize the population. Qualitative variables were expressed as proportions and ranges, quantitative variables as means and standard deviation. Fisher's exact test was used to compare mortality between patients with and without myocardial damage. A p value < 0.05 was considered significant.

RESULTS

From June 2020 to August 2020, 28 patients who met the selection criteria were enrolled, out of which 15 had no myocardial damage and 13 had myocardial damage assessed by serum troponin measurement. A strong association was found between mortality and the presence of myocardial damage, since mortality was 20% (3/15) among patients without myocardial damage and 92.3% (12/13) among those with myocardial damage (Fisher's exact test, p < 0.005).

CONCLUSION

Mortality in patients with COVID-19 is associated with myocardial damage assessed by troponin I measurement.

摘要

背景

2019冠状病毒病（COVID-19）可导致心脏损伤，可能与感染引起的心肌炎和缺血有关。心肌损伤会导致促炎细胞因子的释放，并通过分子限制激活自身免疫适应性机制。

目的

通过肌钙蛋白I测量评估确诊为COVID-19的住院患者中与心肌损伤相关的死亡率。

材料与方法

在一家三级医院的患者队列中进行病例对照研究。使用描述性统计来描述人群特征。定性变量以比例和范围表示，定量变量以均值和标准差表示。采用Fisher精确检验比较有无心肌损伤患者的死亡率。p值<0.05被认为具有统计学意义。

结果

2020年6月至2020年8月，纳入了28例符合入选标准的患者，其中15例无心肌损伤，13例通过血清肌钙蛋白测量评估有心肌损伤。发现死亡率与心肌损伤的存在之间存在密切关联，无心肌损伤患者的死亡率为20%（3/15），有心肌损伤患者的死亡率为92.3%（12/13）（Fisher精确检验，p<0.005）。