Department of Internal Medicine, St. Luke's Hospital, St. Louis, MO, US.
Department of Internal Medicine, University of Massachusetts-Baystate Medical Center, Springfield, MA, USA.
Curr Probl Cardiol. 2024 Nov;49(11):102792. doi: 10.1016/j.cpcardiol.2024.102792. Epub 2024 Aug 11.
Studies exploring predictors of arrhythmias in the population primarily hospitalized for SARS-CoV-2 (COVID-19) are scarce. Understanding this is crucial for risk stratification and appropriate management.
Using the 2020 National Inpatient Sample (NIS) database, we identified primary admissions for COVID-19. A 'greedy neighbor' 1:1 propensity-score matching (PSM) accounted for baseline differences. Then, multivariable logistic regression models were employed to account for confounders and estimate the probability of arrhythmia.
There were a total of 1,058,815 admissions for COVID-19 (mean age 64.3 years ±16.8), 47.2% female, 52.5% (107698) White, 18.5% (37973) Blacks, and 20.7% (42,447) Hispanics. Atrial fibrillation was the most prevalent arrhythmia, 15.1% (31,942). After PSM, 166,405 arrhythmia hospitalizations were matched to 166,405 hospitalizations without arrhythmia. Sick sinus syndrome 4.9 (4.4-5.5), dyslipidemia 1.2 (1.2-1.3), cardiac arrest 1.3 (1.1-1.4), invasive mechanical ventilation 1.9 (1.8-2.0) and obesity 1.3 (1.2-1.4), (p<0.0001, all) were all independent predictors of arrhythmias.
Our analysis revealed a notable proportion of hospitalized COVID-19 patients with arrhythmias. Dyslipidemia, obesity, sick sinus syndrome, invasive mechanical ventilation, and cardiac arrest were independent predictors of arrhythmias.
目前针对因 SARS-CoV-2（COVID-19）住院的人群中心律失常预测因素的研究较为匮乏。了解这些因素对于风险分层和适当的管理至关重要。
利用 2020 年国家住院患者样本（NIS）数据库，我们确定了 COVID-19 的主要入院病例。采用“贪婪邻居”1:1 倾向评分匹配（PSM）来消除基线差异。然后，使用多变量逻辑回归模型来考虑混杂因素并估计心律失常的概率。
共有 1058815 例 COVID-19 住院患者（平均年龄 64.3 岁±16.8），其中 47.2%为女性，52.5%（107698 例）为白人，18.5%（37973 例）为黑人，20.7%（42447 例）为西班牙裔。最常见的心律失常是心房颤动，占 15.1%（31942 例）。在 PSM 后，166405 例心律失常住院患者与 166405 例无心律失常住院患者相匹配。病态窦房结综合征 4.9（4.4-5.5）、血脂异常 1.2（1.2-1.3）、心搏骤停 1.3（1.1-1.4）、有创机械通气 1.9（1.8-2.0）和肥胖 1.3（1.2-1.4）（均 P<0.0001）均是心律失常的独立预测因素。
我们的分析显示，因 COVID-19 住院的患者中存在相当比例的心律失常患者。血脂异常、肥胖、病态窦房结综合征、有创机械通气和心搏骤停是心律失常的独立预测因素。
