对COVID-19相关心肌炎病例报告的系统审查:对治疗方法的讨论
Vanessa Lim1, Gopal Topiwala2, Emiliya Apinova3
1West Virginia School of Osteopathic Medicine, 400 Lee Street North, Lewisburg, WV, 24901, USA. vlim@osteo.wvsom.edu.
Virology journal
|October 10, 2024
概括
即使没有呼吸道症状,COVID-19也可能导致心肌炎等心脏问题. 心脏MRI和类固醇和ECMO等治疗方法对管理这些心脏后果有希望.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 医疗成像医学成像
背景情况:
- COVID-19主要影响呼吸系统,但心肌炎和心膜炎等心脏并发症发生在一小部分患者中.
- 缺乏一种标准化的方法来诊断和治疗COVID-19相关的心脏问题.
- 现有的文献主要由病例报告组成,很少有评论评估许多病例的治疗疗效.
研究的目的:
- 审查现有的病例报告,并评估COVID-19相关心脏瘤的诊断和治疗方法.
- 为了确定COVID-19心肌炎患者的常见临床和诊断发现.
- 评估包括类固醇和ECMO在内的各种治疗方法在治疗心脏并发症中的有效性.
主要方法:
- 来自PubMed,谷歌学者和病例报告期刊的146例患者病例的系统审查.
- 分析患者的人口结构,症状,诊断结果 (心电图,炎症标志物,心脏核磁共振,心声图) 和治疗干预措施.
- 根据接受的治疗,评估患者的治疗结果.
主要成果:
- 脑电图异常,炎症标志物升高和弹射率降低与COVID-19心肌炎有很强的关联.
- 即使在没有呼吸道症状的患者中,也观察到心脏连续病,有时在康复后.
- 在40.4%的病例中使用心脏MRI;在57.5%的病例中使用类固醇.
- 身体外膜氧化 (ECMO) 治疗导致82.1%的患者完全康复.
结论:
- 心脏核磁共振成像和胸前回声心脏成像对于诊断COVID-19心肌炎至关重要.
- 建议在治疗中考虑ECMO,IVIG,类固醇和抗凝剂.
- 需要进一步的随机对照试验来确定治疗结果的最终关联.
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