COVID-19以外の急性呼吸器障害症候群と比較して,重度のCOVID-19における心筋損傷
PubMedで要約を見る
まとめ
この要約は機械生成です。重度のCOVID-19患者の51%で心筋損傷が発生しました. 併発性疾患と関連していますが,COVID-19における不良予後は,心臓損傷だけでなく,重症疾患と臓器機能不全に関連しています.
科学分野
- 心臓病科
- 感染症
- クリティカル ケア 医療
背景
- 心筋損傷は,COVID-19の合併症として認識されていますが,その流行病学と臨床的影響は,特に他の急性呼吸器障害症候群 (ARDS) と比較すると,さらなる解明が必要です.
- 2019年の重症コロナウイルス病 (COVID-19) の患者における心筋損傷の罹患率と予後的な影響に関して,重要な知識のギャップが残っています.
研究 の 目的
- 重度のCOVID-19における心筋損傷の発生率と結果を決定する.
- COVID-19患者の心筋損傷と,COVID-19とは無関係なARDSを患っている患者を比較する.
主な方法
- トロポニン濃度が評価された5つの病院 (2020年3月~6月) のチューブ化されたCOVID-19患者も含まれた.
- 以前のARDSコホート試験の患者と比較した.
- 生存分析は,病院での死亡に焦点を当て,線形回帰は,COVID-19における心筋損傷に関連する要因を特定した.
主要な成果
- COVID-19患者243人のうち51%がトロポニン濃度の上昇を示した.
- 心筋損傷は慢性腎臓病,乳酸,フェリチン,およびフィブリノゲンと関連していました.
- トロポニン濃度が上昇したCOVID-19患者では死亡率が著しく高かった (> 10x ULN: 61. 5% vs < ULN: 22. 7%).
- 調整後,COVID-19 ARDSは,非COVID-19 ARDSと比較して心筋損傷の確率が低いことを示した (OR,0.55;P=0.005).
結論
- 重度のCOVID-19における心筋損傷は,従来のARDSで見られるパターンを反映した,基礎疾患,高齢化,多臓器機能不全によって影響を受けます.
- COVID-19における心筋損傷に関連した不良の予後は,主に広範な多系統臓器の関与と全体的な重篤な疾患の重症性によるものです.
関連する概念動画
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