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与COVID-19相关的急性心肌炎的患病率,特征和结果

Enrico Ammirati¹, Laura Lupi², Matteo Palazzini¹

¹De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milano, Italy (E.A., M.P., P.P. F.S., M.C., C.G.).

|April 11, 2022

概括

急性心肌炎 (AM) 是COVID-19的一种罕见的心血管并发症,每1000例住院病例中发生2.4-4.1例. 结果根据肺炎的存在而异,COVID-19相关肺炎患者的死亡率较高.

科学领域:

心脏病学
传染性疾病
公共卫生

背景情况:

急性心肌炎 (AM) 是COVID-19的一种潜在心血管并发症.
有关COVID-19相关的AM患病率和结果的数据有限.

研究的目的:

确定COVID-19相关的AM的流行,特征,管理和结果.
分析影响住院COVID-19患者的AM结果的因素.

主要方法:

美国和欧洲23家医院对56963名住院的COVID-19患者进行了回顾性队列研究.
纳入标准:因COVID-19和AM诊断而入院 (心内膜活检或CMR发现的高位素).
对患者人口统计,临床表现,治疗和住院/120天的结果进行分析.

主要成果:

确定的/可能的AM患病率为2. 4/1000,可能的AM患病率为4. 1/1000例住院.
年龄中位数为38岁;女性为38.9%. 胸部疼痛和呼吸障碍是常见的症状.
57.4%的病例发生在没有COVID-19肺炎的情况下;38.9%的病例出现了突发性表现.
住院综合结果 (死亡率/机械支持) 为20. 4%. 120天死亡率为6. 6%,肺炎患者的死亡率显著高 (15. 1% 与 0% 相比).
左心室喷射分数显著改善,从40%提高到55%.

结论:

与COVID-19相关的AM很少见,每1000例住院病例中发生2.4-4.1例.
常常没有肺炎,可能导致血液动力学不稳定.
结局受到同时出现的肺炎的影响,如果肺炎存在,预后会更差.

关键词:

在2019年一个MRI 冠状病毒心脏病心肌炎结果

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