心力衰竭和并发症在COVID-19感染中具有负面预后
Antonio E Pontiroli1, Giuseppe Ambrosio2, Olivia Leoni3
1Università degli Studi di Milano, Dipartimento di Scienze della Salute, Milan, Italy.
International journal of cardiology
|June 9, 2025
概括
与没有心力衰竭 (HF) 的患者相比,心力衰竭患者的COVID-19感染,住院和死亡风险明显更高. 年龄,男性性别和先前的HF住院是HF患者不良结果的关键风险因素.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 心血管疾病,包括心力衰竭 (HF),是严重的COVID-19结果的确立危险因素.
- COVID-19大流行不成比例地影响了意大利伦巴第等地区.
- 了解对高频人口的具体影响对于公共卫生战略至关重要.
研究的目的:
- 为了比较COVID-19感染率,住院人数和患有和没有HF的患者之间的死亡率.
- 为了确定COVID-19感染的风险因素和HF患者的全因死亡率.
主要方法:
- 伦巴第地区的一项大型队列研究,比较了98,549名HF患者 (2015-2019年出院) 与394,104名随机选择的非HF患者 (>40岁).
- 对2020年2月21日至10月1日诊断的实验室确认的COVID-19病例的分析.
- 评估的结果包括COVID-19发生,住院和死亡.
主要成果:
- 与没有高血压患者相比,高血压患者的COVID-19感染发病率 (29.65 vs 10.20 / 100,000),住院 (14.97 vs 3.48 / 100,000) 和死亡率 (5.37 vs 0.57 / 100,000) 显着更高.
- 感染,住院和死亡的发病率比率 (IRR) 在HF患者中显著更高 (分别为2.91,4.30和10.60).
- 在HF患者中,晚年,男性性别,先前的HF住院和并发症是感染和死亡的重要风险因素.
结论:
- 心力衰竭是严重COVID-19的重要危险因素,包括感染,住院和死亡率的增加.
- 诸如年龄,男性性别和疾病负担 (先前住院治疗,并发病) 等风险因素,需要针对高风患者进行有针对性的干预.
- 这些发现对于优先考虑预防措施和在流行病期间告知临床管理至关重要.
更多相关视频
相关概念视频
01:27Heart Failure I: Introduction
79
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
79
01:17Pathophysiology of Heart Failure
1.9K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.9K
01:26Imbalances in Cardiac Output
1.6K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.6K
01:26Heart Failure III: Clinical Manifestations
60
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
60
01:29Heart Failure II: Pathophysiology
59
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
59
01:30Heart Failure V: Medical Management
34
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
34