Ciurariu Elena, Balteanu Mara Amalia, Georgescu Marius, Drăghici George Andrei, Vlăsceanu Silviu Gabriel, Șerb Alina-Florina, Cioboată Ramona
Department of Functional Sciences, Physiology Discipline, Faculty of Medicine, "Victor Babeș" University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timişoara, Romania.
Department of Pulmonology, Faculty of Medicine, Titu Maiorescu University, 031593 Bucharest, Romania.
J Clin Med. 2025 Mar 28;14(7):2310. doi: 10.3390/jcm14072310.
: COVID-19 is associated with multiple systemic effects, including cardiovascular complications. However, its interplay with cardiac conduction abnormalities remains underexplored. We compared the clinical profile of COVID-19 patients with pre-existing left bundle branch block (LBBB) or right bundle branch block (RBBB) at hospital admission. : This study included 100 COVID-19 patients with antecedent BBB (50 LBBB, 50 RBBB). Critical cardiometabolic, renal, hematological, and inflammatory markers were measured. Logistic regression was used to identify key predictors differentiating COVID-19 patients with LBBB and RBBB. Spearman's correlations were applied to assess intra-strata associations for these variables. : COVID-19 patients with LBBB patients were significantly more likely to display lower systolic blood pressure ( = 0.012) but greater left atrial size ( = 0.008), left ventricular diameter ( = 0.001), and interventricular septal thickness ( = 0.023). Hematological and inflammatory markers differed, with LBBB patients being prone to exhibit higher red cell distribution width ( = 0.005), lymphocyte count ( < 0.001), neutrophil count ( = 0.045), and C-reactive protein ( < 0.001). This group also tended to show lower erythrocyte sedimentation rate ( = 0.013) and glycated hemoglobin ( = 0.045) but higher random glucose ( = 0.014). Absolute lymphocyte count, C-reactive protein, and left ventricular diameter were the most robust predictors distinguishing LBBB from RBBB. Significant associations were found exclusively for LBBB, all of them being weak. These predominantly negative relationships indicated an inflammatory origin, and most of them occurred for lymphocyte count. : COVID-19 patients with LBBB and RBBB present distinct clinical profiles at hospital admission. The former group demonstrates a more adverse baseline clinical profile, particularly in terms of cardiac and inflammatory markers. These findings suggest that pre-existing BBB type may influence disease progression, potentially helping in risk stratification for COVID-19 patients.
新型冠状病毒肺炎（COVID-19）与多种全身效应相关，包括心血管并发症。然而，其与心脏传导异常之间的相互作用仍未得到充分研究。我们比较了入院时患有既往左束支传导阻滞（LBBB）或右束支传导阻滞（RBBB）的COVID-19患者的临床特征。 ：本研究纳入了100例患有既往束支传导阻滞的COVID-19患者（50例LBBB，50例RBBB）。测量了关键的心脏代谢、肾脏、血液学和炎症标志物。采用逻辑回归来确定区分患有LBBB和RBBB的COVID-19患者的关键预测因素。应用Spearman相关性分析来评估这些变量在各层内的关联。 ：患有LBBB的COVID-19患者更有可能出现较低的收缩压（P = 0.012），但左心房大小更大（P = 0.008）、左心室直径更大（P = 0.001）和室间隔厚度更大（P = 0.023）。血液学和炎症标志物有所不同，LBBB患者更容易出现更高的红细胞分布宽度（P = 0.005）、淋巴细胞计数（P < 0.001）、中性粒细胞计数（P = 0.045）和C反应蛋白（P < 0.001）。该组患者还往往表现出较低的红细胞沉降率（P = 0.013）和糖化血红蛋白（P = 0.045），但随机血糖较高（P = 0.014）。绝对淋巴细胞计数、C反应蛋白和左心室直径是区分LBBB和RBBB的最有力预测因素。仅在LBBB中发现了显著关联，且所有关联都较弱。这些主要为负相关关系表明其起源于炎症，且大多数关联发生在淋巴细胞计数方面。 ：患有LBBB和RBBB的COVID-19患者在入院时呈现出不同的临床特征。前一组表现出更不利的基线临床特征，特别是在心脏和炎症标志物方面。这些发现表明，既往束支传导阻滞类型可能影响疾病进展，可能有助于对COVID-19患者进行风险分层。
