急性COVID-19心血管症候群の説明と提案された管理
Nicholas S Hendren1, Mark H Drazner1, Biykem Bozkurt2
1Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (N.S.H., M.H.D.).
Circulation
|April 17, 2020
まとめ
COVID-19は急性心損傷を引き起こし,心筋不全や不律症として現れます. この心血管症候群の患者にとって 早期の認識と多分野的な治療は不可欠です
科学分野:
- 心臓病科
- 感染症
- クリティカル ケア 医療
背景:
- コロナウイルス病 2019 (COVID-19) パンデミックは,著しい罹病率と死亡率を引き起こす.
- 入院した患者の一部は急性COVID-19心血管症候群を発症し,心臓損傷,心筋病変,心律失調,血液動力学的不安定が特徴です.
- この心臓損傷の正確な原因は不明ですが,潜在的メカニズムには,心筋炎,マイクロ血管損傷,サイトカイン媒介の損傷,またはストレス関連の心筋病気が含まれます.
研究 の 目的:
- 急性COVID-19心血管症候群の流行病学,病原性,診断,治療に関する現在のデータをレビューする.
- この症候群の監視,診断,管理戦略を提案する.
- 患者のリスクと医療従事者の被曝のバランスをとって 臨床結果を改善する
主な方法:
- COVID-19 心血管症候群に関する利用可能な文献のレビュー.
- ウイルスの複製と全身の炎症を含む潜在的な病原性メカニズムの分析.
- 既存の証拠と臨床経験に基づく管理戦略の策定
主要な成果:
- 急性COVID-19心血管症候群は,様々な臨床的症状を呈し,多くの場合,閉塞性冠動脈疾患なしに心臓損傷を含む.
- 潜在的原因には,心臓に直接的なウイルスの影響,全身の炎症,およびストレス誘発の心筋症が含まれます.
- 抗ウイルス薬や免疫調節剤を含む以前のコロナウイルスに対する経験から,治療戦略を評価しています.
結論:
- 急性COVID-19心血管症候群には,心臓病専門医,感染症専門医,重症病棟の医師を含む多学科アプローチが必要です.
- 効果的な管理には 早期の認識と リスクを最小限に抑えながら 患者の結果を最適化する戦略が必要です
- この複雑な状態の病原性を完全に解明し,治療プロトコルを精錬するには,さらなる研究とデータが必要です.
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