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. 2020 Mar 2;48(0):E004.
doi: 10.3760/cma.j.cn112148-20200220-00105. Online ahead of print.

[Clinical Characteristics and Outcomes of 112 Cardiovascular Disease Patients Infected by 2019-nCoV]

[Article in Chinese]
Affiliations

[Clinical Characteristics and Outcomes of 112 Cardiovascular Disease Patients Infected by 2019-nCoV]

[Article in Chinese]
Y D Peng et al. Zhonghua Xin Xue Guan Bing Za Zhi. .

Abstract

Objective: To explore the clinical characteristics and prognosis of the new coronavirus 2019-nCoV patients combined with cardiovascular disease (CVD). Methods: A retrospective analysis was performed on 112 COVID-19 patients with CVD admitted to the western district of Union Hospital in Wuhan, from January 20, 2020 to February 15, 2020. They were divided into critical group (ICU, n=16) and general group (n=96) according to the severity of the disease and patients were followed up to the clinical endpoint. The observation indicators included total blood count, C-reactive protein (CRP), arterial blood gas analysis, myocardial injury markers, coagulation function, liver and kidney function, electrolyte, procalcitonin (PCT), B-type natriuretic peptide (BNP), blood lipid, pulmonary CT and pathogen detection. Results: Compared with the general group, the lymphocyte count (0.74×10(9) (0.34×10(9), 0.94×10(9))/L vs. 0.99×10(9) (0.71×10(9), 1.29×10(9))/L, P=0.03) was extremely lower in the critical group, CRP (106.98 (81.57, 135.76) mg/L vs. 34.34 (9.55,76.54) mg/L, P<0.001) and PCT (0.20 (0.15,0.48) μg/L vs. 0.11 (0.06,0.20)μg/L, P<0.001) were significantly higher in the critical group. The BMI of the critical group was significantly higher than that of the general group (25.5 (23.0, 27.5) kg/m(2) vs. 22.0 (20.0, 24.0) kg/m(2), P=0.003). Patients were further divided into non-survivor group (17, 15.18%) group and survivor group (95, 84.82%). Among the non-survivors, there were 88.24% (15/17) patients with BMI> 25 kg/m(2), which was significantly higher than that of survivors (18.95% (18/95), P<0.001). Compared with the survived patients, oxygenation index (130 (102, 415) vs. 434 (410, 444), P<0.001) was significantly lower and lactic acid (1.70 (1.30, 3.00) mmol/L vs. 1.20 (1.10, 1.60) mmol/L, P<0.001) was significantly higher in the non-survivors. There was no significant difference in the proportion of ACEI/ARB medication between the critical group and the general group or between non-survivors and survivors (all P>0.05). Conclusion: COVID-19 patients combined with CVD are associated with a higher risk of mortality. Critical patients are characterized with lower lymphocyte counts. Higher BMI are more often seen in critical patients and non-survivor. ACEI/ARB use does not affect the morbidity and mortality of COVID-19 combined with CVD. Aggravating causes of death include fulminant inflammation, lactic acid accumulation and thrombotic events.

目的: 研究心血管病(CVD)患者罹患新型冠状病毒肺炎(COVID-19)后的临床特点及转归。 方法: 回顾性分析2020年1月20日至2020年2月15日入武汉协和医院西院的112例COVID-19合并CVD患者,按病情严重程度分为危重组(n=16)和普通组(n=96),观察随访至临床终点。观察指标包括全血细胞计数、C反应蛋白(CRP)、动脉血气分析、心肌损伤标志物、凝血功能、肝肾功能、电解质、降钙素原(PCT)、B型利钠肽(BNP)、血脂、肺部CT及病原学检测。 结果: 与普通组比较,危重组患者淋巴细胞计数[0.74×10(9)(0.34×10(9),0.94×10(9))/L比0.99×10(9)(0.71×10(9),1.29×10(9))/L,P=0.03]较低,CRP[106.98(81.57,135.76)mg/L比34.34(9.55,76.54)mg/L,P<0.001]和PCT[0.20(0.15,0.48)μg/L比0.11(0.06,0.20)μg/L,P<0.001]较高;危重组体重指数(BMI)明显高于普通组[25.5(23.0,27.5)kg/m(2)比22.0(20.0, 24.0)kg/m(2),P=0.003]。112例患者中全因死亡17例(15.18%),治愈95例(84.82%)。死亡患者中,BMI>25 kg/m(2)患者占88.24%(15/17),明显高于治愈患者的18.95%(18/95,P<0.001)。和治愈患者比较,死亡患者血乳酸[1.70(1.30,3.00)mmol/L比1.20(1.10,1.60)mmol/L,P<0.001]较高,氧合指数[130(102,415)比434(410,444),P<0.001]明显偏低。使用ACEI/ARB的患者比例无论在危重组与普通组间还是在死亡与治愈患者间比较,差异均无统计学意义(P均>0.05)。 结论: COVID-19合并CVD病情重病死率较高。危重患者淋巴细胞偏低,危重患者和死亡患者BMI值偏高。ACEI/ARB不影响COVID-19合并CVD患者的发病率和病死率。加剧患者死亡的原因可能与炎症反应、乳酸堆积酸中毒以及恶性心血管事件有关。.

Keywords: COVID-19; Cardiovascular diseases; Treatment outcome.

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