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非缺血性心肌病患者 COVID-19 的住院死亡率和结局:倾向匹配分析。

Inpatient mortality and outcomes of COVID-19 among patients with non-ischemic cardiomyopathy: A propensity matched analysis.

机构信息

Department of Internal Medicine, Asante Three Rivers Medical Center, Grants Pass, OR, USA.

University of Arizona, Tucson, AZ, USA.

出版信息

Heart Lung. 2024 Nov-Dec;68:160-165. doi: 10.1016/j.hrtlng.2024.06.018. Epub 2024 Jul 15.

Abstract

BACKGROUND

Patients with chronic medical conditions, particularly cardiovascular diseases, are at a greater risk of adverse outcomes due to COVID-19. The effect of COVID-19 on patients with non-ischemic cardiomyopathy (NICM) is not known well.

OBJECTIVES

To study the impact of COVID-19 infection on NICM hospital mortality and other outcomes.

METHODS

This study included a cohort of patients from the 2020 and 2021 National Inpatient Sample databases. Patients hospitalized for COVID-19 with and without NICM were matched using a 1:1 propensity score-matching ratio. Outcomes analyzed were in-hospital mortality, rates of acute kidney injury (AKI), acute myocardial infarction (AMI), cardiogenic shock, cardiac arrest, mechanical ventilation, tracheal intubation, pulmonary embolism (PE), ventricular tachycardia (VT), ventricular fibrillation (VF), length of stay (LOS), and total hospitalization charges.

RESULTS

A total of 2,532,652 patients met the inclusion criteria (1,199,008 females [47.3 %], predominantly white 1,456,203 (57.5 %); mean [SD] age 63 [5.4] years), including 64,155 (2.5 %) patients with a history of NICM. Following propensity matching, 10,258 COVID-19 patients with and without NICM were matched. Patients with NICM had higher rates of AMI (11.1 vs. 7.1 %, p < 0.001), cardiogenic shock (2 vs. 0.6 %, p < 0.001), cardiac arrest (4.4 vs. 3.2 %, p < 0.01), mechanical ventilation (13.7 vs 12 %, p < 0.01), VT (8.5 vs. 2.2 %, p < 0.001), and VF (1.0 vs 0.25 %, p < 0.001). The odds ratios for in-hospital mortality, AKI, and PE did not differ significantly.

CONCLUSION

A History of NICM does not affect COVID-19 mortality but increases the risk of cardiovascular complications.

摘要

背景

患有慢性疾病的患者,尤其是心血管疾病患者,由于 COVID-19 而面临更严重的不良后果风险。COVID-19 对非缺血性心肌病(NICM)患者的影响尚不清楚。

目的

研究 COVID-19 感染对 NICM 患者住院死亡率和其他结局的影响。

方法

本研究纳入了 2020 年和 2021 年全国住院患者样本数据库中的患者队列。对因 COVID-19 住院且伴有和不伴有 NICM 的患者采用 1:1 倾向评分匹配比例进行匹配。分析的结局包括住院死亡率、急性肾损伤(AKI)发生率、急性心肌梗死(AMI)、心源性休克、心脏骤停、机械通气、气管插管、肺栓塞(PE)、室性心动过速(VT)、心室颤动(VF)、住院时间(LOS)和总住院费用。

结果

共有 2532652 例患者符合纳入标准(女性 1199008 例[47.3%],白人患者 1456203 例[57.5%];平均[标准差]年龄 63[5.4]岁),其中 64155 例(2.5%)有 NICM 病史。在进行倾向评分匹配后,共匹配了 10258 例 COVID-19 患者,其中伴有和不伴有 NICM 的患者各 5129 例。伴有 NICM 的患者 AMI(11.1% vs. 7.1%,p<0.001)、心源性休克(2% vs. 0.6%,p<0.001)、心脏骤停(4.4% vs. 3.2%,p<0.01)、机械通气(13.7% vs. 12%,p<0.01)、VT(8.5% vs. 2.2%,p<0.001)和 VF(1.0% vs. 0.25%,p<0.001)发生率较高。住院死亡率、AKI 和 PE 的比值比无显著差异。

结论

NICM 病史不会影响 COVID-19 死亡率,但会增加心血管并发症的风险。

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