Nagai Tomoo, Horinouchi Hitomi, Yoshioka Koichiro, Ikari Yuji
Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa, 259-1193, Japan.
J Echocardiogr. 2024 Dec 22. doi: 10.1007/s12574-024-00673-9.
Few investigational reports have evaluated the status of cardiovascular manifestations of coronavirus disease 2019 (COVID-19) during the Omicron dominance period. In this study, we aimed to investigate the cardiac function parameters and clinical outcomes of patients with COVID-19 before and after the Omicron variant (OV) propagation.
We retrospectively analyzed the data of 88 adult patients with COVID-19 who underwent clinically indicated standard transthoracic echocardiography (TTE) in intensive care wards. Patient backgrounds and information on laboratory tests, diagnostic imaging (including TTE), cardiovascular complications, and treatment were reviewed from digitalized medical records.
In the raw data, post-OV patients (n = 39) were relatively older, lighter in body weight, had a more frequent history of hypertension, had worse serum creatinine levels, and a lesser frequency of lung involvement and composite events (in-hospital death and extracorporeal membrane oxygenation installation), with more cardiac complications, compared with pre-OV patients (n = 49). Post-OV patients had worse left ventricular diastolic function than that of pre-OV patients, with better right ventricular function. However, in the propensity-matched adjusted data, no differences were found except lung involvement. Cumulative survival probability plots using the Kaplan-Meier method as to composite events revealed better outcome in post-OV patients when compared with pre-OV patients by the log-rank test (p = 0.027). However, this difference was not observed after background adjustment using propensity-matched data (p = 0.256).
Although the frequencies of some clinical events and hemodynamic abnormalities seemed to vary after OV propagation in critically ill patients with COVID-19, these findings disappeared except lung involvement after the background adjustment.
在奥密克戎毒株占主导期间，很少有研究报告评估2019冠状病毒病（COVID-19）心血管表现的状况。在本研究中，我们旨在调查奥密克戎变异株（OV）传播前后COVID-19患者的心脏功能参数和临床结局。
我们回顾性分析了88例在重症监护病房接受临床指征标准经胸超声心动图（TTE）检查的成年COVID-19患者的数据。从数字化病历中回顾了患者背景以及实验室检查、诊断成像（包括TTE）、心血管并发症和治疗的信息。
在原始数据中，与奥密克戎变异株出现前的患者（n = 49）相比，奥密克戎变异株出现后的患者（n = 39）年龄相对较大，体重较轻，高血压病史更频繁，血清肌酐水平更差，肺部受累及复合事件（院内死亡和体外膜肺氧合装置安装）的频率更低，但心脏并发症更多。奥密克戎变异株出现后的患者左心室舒张功能比奥密克戎变异株出现前的患者差，右心室功能更好。然而，在倾向匹配调整数据中，除了肺部受累外未发现差异。使用Kaplan-Meier方法绘制的复合事件累积生存概率图显示，通过对数秩检验，奥密克戎变异株出现后的患者与奥密克戎变异株出现前的患者相比结局更好（p = 0.027）。然而，在使用倾向匹配数据进行背景调整后未观察到这种差异（p = 0.256）。
尽管在COVID-19重症患者中，奥密克戎变异株传播后某些临床事件和血流动力学异常的频率似乎有所不同，但在背景调整后，除了肺部受累外，这些发现均消失。
