Your browser doesn't support javascript.
loading
Characteristics of myocardial injury in severe and critical coronavirus disease 2019 patients and its effect on prognosis / 第二军医大学学报
Academic Journal of Second Military Medical University ; (12): 596-603, 2020.
Article in Chinese | WPRIM | ID: wpr-837838
ABSTRACT
Objective To analyze the characteristics and related risk factors of myocardial injury in severe and critical coronavirus disease 2019 (COVID-19) patients and their relationship with the prognosis. Methods The clinical data of severe and critical COVID-19 patients treated in General Hospital of Central Theater Command of PLA from Jan. 2020 to Mar. 2020 were collected. The patients were divided into non-myocardial injury group and myocardial injury group. The baseline data, clinical characteristics, auxiliary examination, treatment and prognosis were compared between the two groups, and the risk factors of myocardial injury and the effect on the prognosis of the severe and critical COVID-19 patients were analyzed. Results A total of 56 patients were included, with 22 in the non-myocardial injury group and 34 in the myocardial injury group. Patients were mostly male in both groups, and there was no significant difference in gender composition between the two groups (P>0.05). Compared with the non-myocardial injury group, the age of onset was significantly higher in the myocardial injury group (78.5[ 70.8, 89.0] years vs 56.5[ 50.3, 68.3] years, P0.05). For the CT findings of the lungs, the proportion of patients having patch-like/plaque-like shadows and ground-glass opacities was significantly greater in the non-myocardial injury group versus the myocardial injury group (72.7%[ 16/22] vs 38.2%[ 13/34], χ2=6.364, P0.05). Compared with the non-myocardial injury group, the levels of N-terminal pro-B-type natriuretic peptide, D-dimer, procalcitonin and IL-6 were significantly higher in the myocardial injury group (4 939.5[ 1 817.0, 9 450.3] pg/mL vs 612.5[ 301.0, 1 029.5] pg/mL, 4 386.5 [2 309.5, 9 635.3] ng/mL vs 850.5 [343.5, 2 333.8] ng/mL, 0.46 [0.23, 3.79] ng/mL vs 0.18 [0.13, 0.39] ng/mL, and 138.6 [41.9, 464.8] pg/mL vs 65.1[ 34.7, 99.3] pg/mL, respectively), and the differences were significant (all P0.05). The mortality rate was significantly higher in the myocardial injury than that in the non-myocardial injury group (58.8% [20/34] vs 9.1% [2/22], P<0.01). Patients who received tracheal intubation, extracorporeal membrane oxygenation, continuous renal replacement therapy (CRRT) and other invasive life support measures were all in the myocardial injury group. Conclusion Older age, male gender, coronary heart disease and (or) cardiac insufficiency, and elevated D-dimer, procalcitonin and IL-6 are the risk factors of myocardial injury in severe and critical COVID-19 patients. Myocardial injury can aggravate the condition and some patients need invasive circulating breathing support, with poor prognosis and high mortality. Therefore, the above indicators need to be observed more closely and dynamically and active treatment should be given according to related factors.

Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study / Risk factors Language: Chinese Journal: Academic Journal of Second Military Medical University Year: 2020 Type: Article

Similar

MEDLINE

...
LILACS

LIS

Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study / Risk factors Language: Chinese Journal: Academic Journal of Second Military Medical University Year: 2020 Type: Article