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Objective@#Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear.@*Methods@#A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( @*Results@#Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks.@*Conclusion@#Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , COVID-19/virology , China/epidemiology , Comorbidity , Retrospective Studies , Severity of Illness Index , Treatment OutcomeABSTRACT
Objective·To evaluate the characteristics of different congenital heart diseases (CHD) with mitral regurgitation (MR) by two-dimensional echocardiography. Methods?·?A total of 217 patients with simple CHD and MR and 85 normal children (control group) were enrolled for analysis. All the patients with MR were divided into 3 groups, i.e. ventricular septal defect (VSD) with MR, patent ductus arteriosus (PDA) with MR and coarctation (CoA) with MR. The size of defects, the peak pressure gradient of CoA and the malformation of mitral valve were described respectively in MR groups by echocardiography. In addition, the bore of left atrioventricular cavity, the left ventricular ejection fraction (LVEF) and the diameter of mitral valve annulus were compared with control group. Results?·?Compared with control group, left atrium diameter, left ventricular diameter, mitral annular diameter (MAD), and MAD/tricuspid annulus diameter (MAD/TAD) increased in 3 MR groups, while only LVEF decreased significantly in CoA with MR group. The characteristics of CHD with MR were displayed as below. VSD was with less tissue formation and large defect diameter, the diameters of PDA were over 0.3 cm mostly and the peak pressure gradients of CoA were all above 48?mmHg (1?mmHg=0.133?kPa). Furthermore, there were different mitral valve morphology in the 3 MR groups. Conclusion?·?The mechanism of MR based on CHD may be related to increased atrioventricular cavity, MAD, MAD/TAD and abnormal morphology of mitral valve. These abnormal manifestations observed by two-dimensional echocardiography are useful for surgery in the patients with MR.
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Objective To explore the accuracy of heart function assessment of the left single ventricle problems in children by three-dimensionalechocardiography (3 DE),the doppler myocardial performance index (MPI) and tissue doppler imaging(TDI).Methods Twenty-nine healthy children (the healthy control group) and 29 children with problems in the single left ventricles (the case study group) were enrolled in this study.End-diastolic volume (EDV),end-systolic volume(ESV) and ejection fraction(EF) were acquired by using IE 33 system and Q-lab software between 2 groups.MPI was calculated from doppler tracings on the ventricular inflow and outflow,and the velocity profile of atrioventricular annular was obtained by TDI.Max(dp/dt) of the left single ventricle was estimated by atrioventricular regurgitation using simplified Bernoulli equation.Results EDV,ESV and MPI in the case study group were higher than those of the healthy control group(t =2.821,5.287,2.085,all P ＜0.05),and EF of the case study group was lower than that of the healthy control group(t =-13.840,P ＜ 0.05).Em,Am and Em/Am on the side of the left ventricular lateral wall of mitral annulus in the control group were higher than those of the case study group at the nonresidual cardiac cavity side(t =-3.059,2.219,-4.762,P ＜ 0.05) ;Sm and Em/Am in the healthy control group at mitral annular lateral ventricular septal side were higher than those in the case study group at the residual cardiac cavity side(t =-2.200,-2.962,P ＜0.05).Q-Sm interval in healthy control group was lower than that in the case study group(t =2.345,P ＜ 0.05).There was a negative correlation between Max (dp/dt) and MPI in the case study group (r =-0.57,P ＜0.05),there was a positive correlation between Max(dp/dt) and EF and Q-Sm interval in the case study group(r =-0.74,0.62,P ＜ 0.05).Conclusions Impaired ventricular functions can be found in patients with left single ventricle problems,which can be assessed accurately by 3DE.
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<p><b>OBJECTIVE</b>To discuss the diagnostic methods and features of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA).</p><p><b>METHODS</b>A total of 22 cases of ALCAPA hospitalized between 2000 and 2007 were recruited and divided into infant group (age < or = 1 year, n = 10) and older children group (age > 1 year, n = 12). The patients' history, electrocardiography (ECG) and echocardiography were reviewed and analyzed retrospectively. ECGs were analyzed as follows: (1) Q wave and T wave inversion in lead I, (2) Abnormal Q wave and T wave inversion in lead aVL, (3) Q wave in lead V(5-6), (4) T wave inversion and ST changes in lead V(4-6), (5) LV hypertrophy. Echocardiograms were analyzed as follows: (1) Continuity of the left coronary artery (LCA) and pulmonary artery (PA), (2) Retrograde shunt into PA, (3) Increased papillary muscle echodensity, (4) Right coronary artery (RCA) dilation, (5) Collateral signals within the ventricular septum.</p><p><b>RESULTS</b>The presence of cardiomegaly in X-ray film (18/22), aVL QT pattern in ECG (17/22), retrograde color Doppler flow into pulmonary artery (20/22), anterior lateral papillary echogenic (17/22) and collateral vessel signals (16/22) in echocardiography were high in both groups (P > 0.05). The presence of clinical symptoms and abnormal Q wave in leads Iand V(5-6) in ECG were significantly higher in the infant group than in the older children group (P < 0.05). But the presence of right coronary artery dilation was significantly lower in the infant group than in the older children group (P < 0.05).</p><p><b>CONCLUSION</b>Different diagnostic features were found in infant and older children patients. With combination of patient history, electrocardiogram and echocardiogram, accurate diagnosis could be obtained in most pediatric patients with ALCAPA.</p>