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首页> 外文期刊>The American Journal of Cardiology >Cardiac Injury Patterns and Inpatient Outcomes Among Patients Admitted With COVID-19
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Cardiac Injury Patterns and Inpatient Outcomes Among Patients Admitted With COVID-19

机译：Covid-19承认的患者的心脏损伤模式和住院性结果

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摘要

Although certain risk factors have been associated with increased morbidity and mortality in patients admitted with Coronavirus Disease 2019 (COVID-19), the impact of cardiac injury and high-sensitivity troponin-I (hs-cTnI) concentrations are not well described. In this large retrospective longitudinal cohort study, we analyzed the cases of 1,044 consecutively admitted patients with COVID-19 from March 9 until April 15. Cardiac injury was defined by hs-cTnI concentration >99th percentile. Patient characteristics, laboratory data, and outcomes were described in patients with cardiac injury and different hs-cTnI cut-offs. The primary outcome was mortality, and the secondary outcomes were length of stay, need for intensive care unit care or mechanical ventilation, and their different composites. The final analyzed cohort included 1,020 patients. The median age was 63 years, 511 (50% patients were female, and 403 (40% were white. 390 (38%) patients had cardiac injury on presentation. These patients were older (median age 70 years), had a higher cardiovascular disease burden, in addition to higher serum concentrations of inflammatory markers. They also exhibited an increased risk for our primary and secondary outcomes, with the risk increasing with higher hs-cTnI concentrations. Peak hs-cTnI concentrations continued to be significantly associated with mortality after a multivariate regression controlling for comorbid conditions, inflammatory markers, acute kidney injury, and acute respiratory distress syndrome. Within the same multivariate regression model, presenting hs-cTnI concentrations were not significantly associated with outcomes, and undetectable hs-cTnI concentrations on presentation did not completely rule out the risk for mechanical ventilation or death. In conclusion, cardiac injury was common in patients admitted with COVID-19. The extent of cardiac injury and peak hs-cTnI concentrations were associated with worse outcomes. (c) 2020 Elsevier Inc. All rights reserved.
机译：尽管某些风险因素与2019年冠状病毒病（COVID-19）患者的发病率和死亡率增加有关，但心脏损伤和高敏肌钙蛋白-I（hs-cTnI）浓度的影响尚不清楚。在这个2019冠状病毒疾病的大型回顾性队列研究中，我们分析了3月9日至4月15日共1044例COVID-19患者的病例。心脏损伤定义为hs-cTnI浓度>99%。描述了心脏损伤和不同hs-cTnI临界值患者的患者特征、实验室数据和结果。主要结果是死亡率，次要结果是住院时间、重症监护病房护理或机械通气的需要，以及它们的不同组合。最终分析的队列包括1020名患者。中位年龄为63岁，511名（50%）患者为女性，403名（40%）患者为白人。390名（38%）患者出现心脏损伤。这些患者年龄较大（中位年龄70岁），除血清炎症标志物浓度较高外，心血管疾病负担也较高。他们还表现出我们的主要和次要结果的风险增加，随着hs-cTnI浓度的升高，风险增加。在对共病情况、炎症标志物、急性肾损伤和急性呼吸窘迫综合征进行多元回归分析后，hs-cTnI峰值浓度继续与死亡率显著相关。在同一多元回归模型中，呈现的hs-cTnI浓度与预后无显著相关性，呈现时检测不到的hs-cTnI浓度并不能完全排除机械通气或死亡的风险。2019冠状病毒疾病患者心脏损害较常见。心脏损伤程度和hs-cTnI峰值浓度与不良预后相关。（c） 2020爱思唯尔公司版权所有。

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