Dominika Krogulec , Carlo Bieńkowski , Justyna D. Kowalska , Agnieszka Bednarska , Beata Wojtycha-Kwaśnica , Natalia Jurek , Piotr Ząbek , Hanna Czeszko-Paprocka , Monika Mrozińska , Marcin Paciorek , Andrzej Pihowicz , Andrzej Horban
{"title":"COVID-19治疗过程中的心血管并发症--汲取的教训和对未来治疗病毒性呼吸道疾病患者的启示：来自单中心回顾性观察研究的数据。","authors":"Dominika Krogulec , Carlo Bieńkowski , Justyna D. Kowalska , Agnieszka Bednarska , Beata Wojtycha-Kwaśnica , Natalia Jurek , Piotr Ząbek , Hanna Czeszko-Paprocka , Monika Mrozińska , Marcin Paciorek , Andrzej Pihowicz , Andrzej Horban","doi":"10.1016/j.hrtlng.2024.06.009","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Factors associated with cardiovascular complications of COVID-19 remain understudied.</p></div><div><h3>Objectives</h3><p>Here we investigate the occurrence and risk factors of arrythmias, myocardial infarction and/or stroke, and thromboembolism in the course of COVID-19.</p></div><div><h3>Methods</h3><p>We have performed an observational study with prospectively designed data collection. Data of patients diagnosed with COVID-19 who were admitted from March 6th 2020 to November 30th 2021 in our Hospital were analyzed. Logistic regression was used to identify variables associated with the odds of early hospital death due to COVID-19.</p></div><div><h3>Results</h3><p>Fourteen-point three percent of 1964 patients had cardiovascular complications, 6.36 % arrhythmias, 5.5 % thromboembolic events and 2.39 % myocardial infarction and/or stroke. Factors independently increasing the odds of arrhythmia were older age (OR=1.49 [95 % CI: 1.17–1.92], <em>p</em> = 0.02), longer time between admission and the first onset of symptoms (1.02 [0.99–1.05], <em>p</em> = 0.049), concomitant atrial fibrillation/flutter (2.84 [1.37–5.70], <em>p</em> = 0.004), nicotinism (2.49 [1.37–4.49], <em>p</em> = 0.002), and eGFR<60 ml/min/1.73m<sup>2</sup> (2.44 [1.08–5.59], <em>p</em> = 0.033). Factors independently increasing the odds of myocardial infarction and/or stroke were dementia (4.55 [0.97–19.3], <em>p</em> = 0.044), hemiplegia (12.67 [3.12–46.1], <em>p</em> < 0.001), nicotinism (3.36 [1.30–10.4], <em>p</em> = 0.013) and higher C-reactive protein concentration (1.01 [1.00–1.01], <em>p</em> = 0.040). Factors independently increasing the odds of thromboembolic events were longer hospitalization (1.08 [1.05–1.10], <em>p</em> < 0.001) and higher d-dimers (1.04 [1.02–1.05], <0.001).</p></div><div><h3>Conclusions</h3><p>The risk of cardiovascular complications was especially pronounced in patients with older age, pre-existing cardiovascular disease and more sever pneumonia at presentation to care. This underlines the importance of close and careful clinical follow-up in the course of COVID-19 for specific patients’ populations, including a pro-active approach in diagnosis.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 116-125"},"PeriodicalIF":2.4000,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324001171/pdfft?md5=4e8f234ff8ab86049b7b594b4da96895&pid=1-s2.0-S0147956324001171-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Cardiovascular complications in the course of COVID-19 - lessons learned and implications for the future care of patients with viral respiratory diseases: Data from a single center retrospective observational study\",\"authors\":\"Dominika Krogulec , Carlo Bieńkowski , Justyna D. Kowalska , Agnieszka Bednarska , Beata Wojtycha-Kwaśnica , Natalia Jurek , Piotr Ząbek , Hanna Czeszko-Paprocka , Monika Mrozińska , Marcin Paciorek , Andrzej Pihowicz , Andrzej Horban\",\"doi\":\"10.1016/j.hrtlng.2024.06.009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Factors associated with cardiovascular complications of COVID-19 remain understudied.</p></div><div><h3>Objectives</h3><p>Here we investigate the occurrence and risk factors of arrythmias, myocardial infarction and/or stroke, and thromboembolism in the course of COVID-19.</p></div><div><h3>Methods</h3><p>We have performed an observational study with prospectively designed data collection. Data of patients diagnosed with COVID-19 who were admitted from March 6th 2020 to November 30th 2021 in our Hospital were analyzed. Logistic regression was used to identify variables associated with the odds of early hospital death due to COVID-19.</p></div><div><h3>Results</h3><p>Fourteen-point three percent of 1964 patients had cardiovascular complications, 6.36 % arrhythmias, 5.5 % thromboembolic events and 2.39 % myocardial infarction and/or stroke. Factors independently increasing the odds of arrhythmia were older age (OR=1.49 [95 % CI: 1.17–1.92], <em>p</em> = 0.02), longer time between admission and the first onset of symptoms (1.02 [0.99–1.05], <em>p</em> = 0.049), concomitant atrial fibrillation/flutter (2.84 [1.37–5.70], <em>p</em> = 0.004), nicotinism (2.49 [1.37–4.49], <em>p</em> = 0.002), and eGFR<60 ml/min/1.73m<sup>2</sup> (2.44 [1.08–5.59], <em>p</em> = 0.033). Factors independently increasing the odds of myocardial infarction and/or stroke were dementia (4.55 [0.97–19.3], <em>p</em> = 0.044), hemiplegia (12.67 [3.12–46.1], <em>p</em> < 0.001), nicotinism (3.36 [1.30–10.4], <em>p</em> = 0.013) and higher C-reactive protein concentration (1.01 [1.00–1.01], <em>p</em> = 0.040). Factors independently increasing the odds of thromboembolic events were longer hospitalization (1.08 [1.05–1.10], <em>p</em> < 0.001) and higher d-dimers (1.04 [1.02–1.05], <0.001).</p></div><div><h3>Conclusions</h3><p>The risk of cardiovascular complications was especially pronounced in patients with older age, pre-existing cardiovascular disease and more sever pneumonia at presentation to care. This underlines the importance of close and careful clinical follow-up in the course of COVID-19 for specific patients’ populations, including a pro-active approach in diagnosis.</p></div>\",\"PeriodicalId\":55064,\"journal\":{\"name\":\"Heart & Lung\",\"volume\":\"68 \",\"pages\":\"Pages 116-125\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-06-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S0147956324001171/pdfft?md5=4e8f234ff8ab86049b7b594b4da96895&pid=1-s2.0-S0147956324001171-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart & Lung\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0147956324001171\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart & Lung","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0147956324001171","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Cardiovascular complications in the course of COVID-19 - lessons learned and implications for the future care of patients with viral respiratory diseases: Data from a single center retrospective observational study
Background
Factors associated with cardiovascular complications of COVID-19 remain understudied.
Objectives
Here we investigate the occurrence and risk factors of arrythmias, myocardial infarction and/or stroke, and thromboembolism in the course of COVID-19.
Methods
We have performed an observational study with prospectively designed data collection. Data of patients diagnosed with COVID-19 who were admitted from March 6th 2020 to November 30th 2021 in our Hospital were analyzed. Logistic regression was used to identify variables associated with the odds of early hospital death due to COVID-19.
Results
Fourteen-point three percent of 1964 patients had cardiovascular complications, 6.36 % arrhythmias, 5.5 % thromboembolic events and 2.39 % myocardial infarction and/or stroke. Factors independently increasing the odds of arrhythmia were older age (OR=1.49 [95 % CI: 1.17–1.92], p = 0.02), longer time between admission and the first onset of symptoms (1.02 [0.99–1.05], p = 0.049), concomitant atrial fibrillation/flutter (2.84 [1.37–5.70], p = 0.004), nicotinism (2.49 [1.37–4.49], p = 0.002), and eGFR<60 ml/min/1.73m2 (2.44 [1.08–5.59], p = 0.033). Factors independently increasing the odds of myocardial infarction and/or stroke were dementia (4.55 [0.97–19.3], p = 0.044), hemiplegia (12.67 [3.12–46.1], p < 0.001), nicotinism (3.36 [1.30–10.4], p = 0.013) and higher C-reactive protein concentration (1.01 [1.00–1.01], p = 0.040). Factors independently increasing the odds of thromboembolic events were longer hospitalization (1.08 [1.05–1.10], p < 0.001) and higher d-dimers (1.04 [1.02–1.05], <0.001).
Conclusions
The risk of cardiovascular complications was especially pronounced in patients with older age, pre-existing cardiovascular disease and more sever pneumonia at presentation to care. This underlines the importance of close and careful clinical follow-up in the course of COVID-19 for specific patients’ populations, including a pro-active approach in diagnosis.
期刊介绍：
Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders.
The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.
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