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新型冠状病毒肺炎门诊患者血液学参数与心悸之间的潜在相关性:一项回顾性研究

Potential Correlation Between Hematological Parameters and Palpitation in Outpatients With COVID-19: A Retrospective Study.

作者信息

Zhang Lei, Chen Ting, Wei Ling, Ren Juan, Gong Jing, Yuan Hui, Liu QingJun

机构信息

Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Insitute of Analysis and Testing, Beijing Academy of Science and Technology (Beijing Center for Physical and Chemical Analysis), Beijing, China.

出版信息

J Clin Lab Anal. 2025 Jan;39(2):e25137. doi: 10.1002/jcla.25137. Epub 2025 Jan 14.

Abstract

BACKGROUND

Research on heart injury caused by COVID-19 is limited to large observational and retrospective cohort studies using imaging or pathological data. Reported changes in the levels of myocardial markers in severe diseases have been limited, with few studies on mild infections. The effects of COVID-19 on cardiac function and changes in myocardial marker levels have not yet been reported.

METHODS

We analyzed data from outpatient blood samples collected at Beijing Anzhen Hospital during the 2022 COVID-19 outbreak and used the same periods in 2020 and 2021 as controls, focusing on changes in routine blood tests, coagulation, myocardial markers, and other blood indices in patients with palpitations.

RESULTS

The number of patients with palpitations increased by 4.87-fold during the COVID-19 mass outbreak in 2022. The indices of myocardial damage did not show any symptom-related increases but decreased within the normal range. The proportion of patients with palpitations whose D-dimer and fibrinogen/fibrin degradation product (FDP) values exceeded the reference ranges increased, as did the numbers of neutrophils, monocytes, and platelets. In this retrospective analysis, we found little change in the myocardial markers in patients with mild COVID-19.

CONCLUSIONS

In patients with mild COVID-19, attention should be diverted from detecting myocardial markers to changes in coagulation test results, focusing on the levels of coagulation indices to improve circulation and prevent thrombosis.

摘要

背景

关于新型冠状病毒肺炎(COVID-19)所致心脏损伤的研究仅限于使用影像学或病理数据的大型观察性和回顾性队列研究。关于重症疾病中心肌标志物水平变化的报道有限,轻度感染的相关研究较少。COVID-19对心脏功能的影响以及心肌标志物水平的变化尚未见报道。

方法

我们分析了北京安贞医院在2022年COVID-19疫情期间采集的门诊血样数据,并以2020年和2021年同期作为对照,重点关注心悸患者的血常规、凝血、心肌标志物及其他血液指标的变化。

结果

2022年COVID-19大规模暴发期间,心悸患者数量增加了4.87倍。心肌损伤指标未出现与症状相关的升高,而是在正常范围内下降。心悸患者中D-二聚体和纤维蛋白原/纤维蛋白降解产物(FDP)值超过参考范围的比例增加,中性粒细胞、单核细胞和血小板数量也增加。在这项回顾性分析中,我们发现轻度COVID-19患者的心肌标志物变化不大。

结论

对于轻度COVID-19患者,应将关注重点从检测心肌标志物转向凝血检查结果的变化,关注凝血指标水平以改善循环并预防血栓形成。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ca6/11776496/d22c9c0d6aee/JCLA-39-e25137-g005.jpg

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