Amir-Kabirian Borna, Annie Frank H, Koontz Morgan, Ihle Rayan
Internal Medicine, CAMC Institute for Academic Medicine, Charleston, USA.
Cardiology, CAMC Institute for Academic Medicine, Charleston, USA.
Cureus. 2024 Mar 31;16(3):e57320. doi: 10.7759/cureus.57320. eCollection 2024 Mar.
Background Within the cardiovascular system, sinus tachycardia has been a noted finding in patients with post-COVID-19 syndrome (symptoms persisting beyond 12 weeks post-infection). To better understand post-COVID-19 tachycardia, we examined the prevalence of sinus tachycardia 12-16 weeks after diagnosis of SARS-COV-2 infection and its correlation with intensive care utilization, ventilator use, and mortality in vaccinated and unvaccinated patients. Methods We identified adult patients in the TriNetX COVID-19 Research Network with confirmed SARS-COV-2 diagnosis from January 20th, 2020, to February 14th, 2022, and sinus tachycardia 12-16 weeks after diagnosis. Two cohorts were created: patients who developed tachycardia 12 weeks after initial diagnosis and patients without tachycardia. The tachycardia cohort was divided further based on vaccination status. Results Of 1,363,907 patients included, 30,705 (2.2%) developed tachycardia. The patients with tachycardia had more comorbidities. Using propensity score matching (PSM), two cohorts of 30,702 were created. The SARS-COV-2 tachycardic cohort had higher mortality (5.1% vs 2.1%, p<0.001), critical care utilization (5.8% vs 2.2%, p<0.001), and ventilator use (1.8% vs 0.5%, p<0.001). Out of 22,878 patients with persistent tachycardia and recorded vaccination status, 14,840 (65%) were not vaccinated. Mortality (5.9% vs 2.3%, p<0.001), critical care utilization (8.3% vs 3.6%, p<0.001), and ventilator use (3.8% vs 0.6%, p<0.001) were higher in the non-vaccinated patients compared with the vaccinated patients after PSM. Conclusion The prevalence of persistent tachycardia after SARS-COV-2 infection is notable at 2.2%. Patients with persistent tachycardia have higher mortality rates and demonstrate greater healthcare utilization at one year compared to patients without persistent tachycardia, particularly if unvaccinated.
背景 在心血管系统中，窦性心动过速是新冠后综合征（感染后12周以上症状仍持续）患者的一个显著发现。为了更好地了解新冠后心动过速，我们研究了严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染诊断后12至16周窦性心动过速的患病率及其与接种疫苗和未接种疫苗患者的重症监护使用率、呼吸机使用情况和死亡率的相关性。方法 我们在TriNetX新冠研究网络中确定了2020年1月20日至2022年2月14日期间确诊为SARS-CoV-2感染且诊断后12至16周出现窦性心动过速的成年患者。创建了两个队列：初始诊断后12周出现心动过速的患者和未出现心动过速的患者。心动过速队列根据疫苗接种状况进一步细分。结果 在纳入的1363907例患者中，30705例（2.2%）出现心动过速。出现心动过速的患者合并症更多。使用倾向评分匹配（PSM）方法，创建了两个各有30702例患者的队列。SARS-CoV-2心动过速队列的死亡率更高（5.1%对2.1%，p<0.001）、重症监护使用率更高（5.8%对2.2%，p<0.001）以及呼吸机使用率更高（1.8%对0.5%，p<0.001）。在22878例有持续性心动过速且记录了疫苗接种状况的患者中，14840例（65%）未接种疫苗。倾向评分匹配后，未接种疫苗患者的死亡率（5.9%对2.3%，p<0.001）、重症监护使用率（8.3%对3.6%，p<0.001）和呼吸机使用率（3.8%对0.6%，p<0.001）均高于接种疫苗的患者。结论 SARS-CoV-2感染后持续性心动过速的患病率为2.2%，值得关注。与无持续性心动过速的患者相比，持续性心动过速患者的死亡率更高，且在一年时的医疗保健利用率更高，尤其是未接种疫苗的患者。
