重症监护中的心血管COVID-19患者:系统综述

Barbara Mayumi Sansana Lee, Winnie da Silva Alves
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摘要

目的:分析因新型冠状病毒肺炎(Covid-19)住院重症监护病房(ICU)患者心血管疾病(CVD)患病率和心脏或血管功能障碍的发生情况。方法:综合文献综述,检索数据库为:BVS、BDENF和LILACS;PuBMED: MEDLINE;科学网与中国科学院。纳入标准,2019年以后出版的葡萄牙语、英语或西班牙语全文文章。结果:选择了6篇文章,列出了3个中心主题:既往CVD患者;住院期间发生心脏或血管疾病的患者;心脏损伤和纤维蛋白降解生物标志物发生改变的患者。CVD的患病率在0%至29%之间,如冠状动脉疾病、心律失常、瓣膜和心室功能障碍,CVD的发病率在2.6%至59%之间,表现为电、功能、结构改变和心源性休克。结论:在ICU收治的Covid-19患者中,既往有CVD和发展为CVD的比例很高。然而,在本研究结束之前,并没有100%的样本以前患有心血管疾病的研究,这对于了解心血管疾病可能造成的损害很重要。与此同时,专门研究心脏损伤类型的研究也在增加,这些研究只被命名为“心脏损伤”或生物标志物。作为本研究的局限性,我们强调在其结论之后进行了新的研究,这肯定会增加更好的知识。这样,人们仍然担心Covid-19会影响既往心血管疾病患者及其心血管症状的严重程度。
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PACIENTES CARDIOVASCULARES COM COVID-19 EM TERAPIA INTENSIVA: UMA REVISÃO SISTEMÁTICA
OBJECTIVE: Analyse in the literature, the prevalence of cardiovascular diseases (CVD) and the development of cardiac or vascular dysfunctions, in individuals hospitalized in intensive care units (ICU), due to Covid-19. METHODS: Integrative literature review, carried out in the databases: BVS: BDENF and LILACS; PuBMED: MEDLINE; Web of Science and CINAHL. Inclusion criteria, full-text articles, in Portuguese, English or Spanish, published from 2019 onwards. RESULTS: Six articles were selected, and three central themes listed: patients with previous CVD; patients who developed heart or vascular diseases during hospitalization; and patients who presented alterations in biomarkers of cardiac injury and fibrin degradation. A prevalence of CVD between 0 and 29% of the studies was observed, as coronary diseases, arrhythmias, valvular and ventricular dysfunctions, and the incidence of CVD between 2.6 and 59%, presenting electrical, functional, structural alterations and cardiogenic shock. CONCLUSION: An important percentage of patients with Covid-19, admitted to the ICU, who had previous CVD and who developed CVD were identified. However, until the end of this study, there weren’t studies in which 100% of the sample had previous CVD, which would be important for understanding the possible impairments under it. Even as, research that specified the types of involvement developed, named only as “cardiac injuries” or biomarkers increased. As limitations of this study, we emphasize that new research was carried out after its conclusion, which will certainly add better knowledge. This way, the concern about the severity in which Covid-19 can affect people with previous CVD and its cardiovascular manifestations remains.
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