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Eur Heart J:既往有心脏病的COVID-19住院患者临床表现、病程和结局

2021-11-06 MedSci原创 MedSci原创

心脏病亚型与住院死亡率之间的关联强度存在相当大的异质性。在所有心脏病患者中,心衰患者因COVID-19住院的死亡风险最大。住院期间很少发生严重的心脏并发症。

自2019年12月以来,2019冠状病毒病(COVID-19)在全球迅速蔓延,截至2021年9月19日,已确诊病例超过2.25亿,死亡人数接近470万。患有心脏病的患者被认为在COVID-19住院后出现不良结果的高风险。

近日,血管领域权威杂志Eur Heart J上发表了一篇研究文章,该研究的目的是评估各种心脏病亚型与患者院内死亡率之间关联的异质性。

研究人员使用了CAPACITY-COVID登记中心和LEOSS研究的数据,并拟合多变量泊松回归模型以评估不同类型的心脏病与患者住院死亡率之间的关联。

该研究共纳入了16511名COVID-19患者(21.1%的患者年龄在66-75岁;40.2%为女性),31.5%的受试者有心脏病史。伴有心脏病的患者年龄较大,主要为男性,与不伴有心脏病的患者相比,通常有其他合并症。心脏病患者的死亡率更高(29.7%;n=1545 vs. 15.9%;n=1797)。然而,经过多变量调整后,这种差异并不显著[调整后的风险比(aRR)为1.08,95%置信区间(CI)为1.02-1.15;P=0.12]。心脏病亚型与院内死亡率的相关性差异很大,与心力衰竭的相关性最强(aRR为1.19,95%CI为1.10-1.30;P<0.018),尤其是重度(纽约心脏协会III/IV级)心力衰竭(aRR为1.41,95%CI为1.20-1.64;P<0.018)。在多变量调整后,包括缺血性心脏病在内的其他心脏病亚型均不显著。1%以下的患者被诊断出严重的心脏并发症。

由此可见,心脏病亚型与住院死亡率之间的关联强度存在相当大的异质性。在所有心脏病患者中,心衰患者因COVID-19住院的死亡风险最大。住院期间很少发生严重的心脏并发症。

原始出处:

The CAPACITY-COVID Collaborative Consortium and LEOSS Study Group.et al.Clinical presentation, disease course, and outcome of COVID-19 in hospitalized patients with and without pre-existing cardiac disease: a cohort study across 18 countries.European Heart Journal.2021.https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehab656/6420641

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    2021-11-08 zhaojie88
  2. [GetPortalCommentsPageByObjectIdResponse(id=1357823, encodeId=e283135e82333, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Nov 08 01:41:10 CST 2021, time=2021-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563543, encodeId=e97e1563543b0, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Nov 08 01:41:10 CST 2021, time=2021-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1067528, encodeId=0b0a106e528e3, content=很详细的讲解,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=65aa5643711, createdName=小白努力长高高, createdTime=Sat Nov 06 11:33:40 CST 2021, time=2021-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1067509, encodeId=bf7a106e5094f, content=热点话题, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c2615440602, createdName=ms3000001529090286, createdTime=Sat Nov 06 10:43:53 CST 2021, time=2021-11-06, status=1, ipAttribution=)]
    2021-11-08 slcumt
  3. [GetPortalCommentsPageByObjectIdResponse(id=1357823, encodeId=e283135e82333, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Nov 08 01:41:10 CST 2021, time=2021-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563543, encodeId=e97e1563543b0, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Nov 08 01:41:10 CST 2021, time=2021-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1067528, encodeId=0b0a106e528e3, content=很详细的讲解,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=65aa5643711, createdName=小白努力长高高, createdTime=Sat Nov 06 11:33:40 CST 2021, time=2021-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1067509, encodeId=bf7a106e5094f, content=热点话题, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c2615440602, createdName=ms3000001529090286, createdTime=Sat Nov 06 10:43:53 CST 2021, time=2021-11-06, status=1, ipAttribution=)]
    2021-11-06 小白努力长高高

    很详细的讲解,谢谢

    0

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    2021-11-06 ms3000001529090286

    热点话题

    0

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