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未接种新冠病毒疫苗、肥胖以及心血管疾病并存作为既往感染过严重急性呼吸综合征冠状病毒2(SARS-CoV-2)患者心电图改变数量增加的独立预测因素。

Lack of Vaccination Against COVID-19, Obesity and Coexistence of Cardiovascular Diseases as Independent Predictors of a Higher Number of ECG Changes in Patients with Previous SARS-CoV-2 Infection.

作者信息

Beck Ewelina, Malczyk Agata, Dykiert Irena, Fułek Michał, Fułek Katarzyna, Poręba Małgorzata, Gać Paweł, Poręba Rafał

机构信息

Department of Environmental Health, Occupational Medicine and Epidemiology, Wroclaw Medical University, 50-345 Wroclaw, Poland.

Department of Diabetology, Hypertension and Internal Diseases, Institute of Internal Diseases, Wroclaw Medical University, 50-556 Wroclaw, Poland.

出版信息

J Clin Med. 2025 Mar 28;14(7):2329. doi: 10.3390/jcm14072329.

Abstract

Many studies have confirmed the existence of a relationship between SARS-CoV-2 virus infection and an increased incidence of arrhythmia in the population of adults, children and adolescents. It is believed that one of the potential side effects of COVID-19 vaccination is arrhythmia. However, large-scale studies confirming the relationship between COVID-19 vaccination and cardiac arrhythmia are currently lacking. The objective of this study was to analyze the occurrence of arrhythmias in 24 h Holter ECG monitoring among patients who had experienced COVID-19, comparing those who were vaccinated against SARS-CoV-2 with those who were unvaccinated. The study was performed on a study group of 237 patients, who underwent 24 h Holter monitoring. Ventricular extrasystoles (VEs) were distinctively more common in patients, who had COVID-19 infection and were not vaccinated for COVID-19 comparing to the control group. Similarly, research has shown that supraventricular extrasystoles (SVEs) occurred remarkably more frequently in both unvaccinated and vaccinated patients after COVID-19 infection in relation to control groups. Multivariable regression analysis demonstrates that, in the whole study group, obesity, arterial hypertension, previous myocardial infarction and lack of vaccination against COVID-19 are independent risk factors for higher VE rates. Obesity, diabetes type 2 and lack of vaccination against COVID-19 are independent risk factors for higher SVE rates. The use of β-blockers is an independent protective factor against higher VE and SVE rates, and the use of ACE inhibitors against higher SVE rates. In this study, the authors obtained promising results for the future, facilitating further discussion and research on the topic of the antiarrhythmic advantages of COVID-19 vaccination. Moreover, the knowledge acquired in this study serves as a valuable tool for effectively promoting COVID-19 vaccination among patients.

摘要

许多研究已证实,在成年人、儿童和青少年群体中,感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)病毒与心律失常发病率增加之间存在关联。人们认为,2019冠状病毒病(COVID-19)疫苗接种的潜在副作用之一是心律失常。然而,目前缺乏大规模研究来证实COVID-19疫苗接种与心律失常之间的关系。本研究的目的是分析经历过COVID-19的患者在24小时动态心电图监测中心律失常的发生情况,将接种SARS-CoV-2疫苗的患者与未接种疫苗的患者进行比较。该研究在一个由237名患者组成的研究组中进行,这些患者接受了24小时动态监测。与对照组相比,感染COVID-19且未接种COVID-19疫苗的患者室性期前收缩(VEs)明显更为常见。同样,研究表明,与对照组相比,COVID-19感染后未接种疫苗和接种疫苗的患者室上性期前收缩(SVEs)的发生频率均显著更高。多变量回归分析表明,在整个研究组中,肥胖、动脉高血压、既往心肌梗死以及未接种COVID-19疫苗是VEs发生率较高的独立危险因素。肥胖、2型糖尿病以及未接种COVID-19疫苗是SVEs发生率较高的独立危险因素。使用β受体阻滞剂是预防VEs和SVEs发生率升高的独立保护因素,使用血管紧张素转换酶(ACE)抑制剂是预防SVEs发生率升高的独立保护因素。在本研究中,作者取得了对未来有前景的结果,便于就COVID-19疫苗接种的抗心律失常优势这一主题进行进一步的讨论和研究。此外,本研究中获得的知识是在患者中有效推广COVID-19疫苗接种的宝贵工具。

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