COVID-19患者住院死亡率和炎症标志物与缺血性心脏病之间的关系

V. Tashchuk, R. Nesterovska, V. Kalarash
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摘要

本研究的目的是探讨COVID-19缺血性心脏病(IHD)患者的医院死亡率与全身炎症标志物之间的关系。材料和方法。对住院治疗的52例COVID-19合并IHD患者的资料进行分析。第一组40例患者康复出院,第二组12例患者死亡。根据患者入院时外周血白细胞数和细胞组成判断所选患者的全身性炎症综合征程度,并根据所得数据计算血液学积分指标值。已经证实,死于COVID-19相关心血管并发症的II组患者全身炎症反应水平明显升高,表现为总白细胞含量显著升高,中性粒细胞百分比升高,淋巴细胞百分比降低,且明显高于血液学综合指标:白细胞移位指数、中性粒细胞与淋巴细胞比值指数、中性粒细胞与单核细胞比值指数。在全身性炎症反应中,已经观察到炎症过程加重了冠状动脉粥样硬化斑块,使其更容易破裂。因此,我们可以假设现有的IHD合并炎症反应增强可导致SARS-CoV感染患者的心脏损伤- 2。淋巴细胞减少、炎症级联过度激活和心脏损伤是COVID-19疾病的重要特征,具有很高的预测价值。
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The connection between hospital mortality and inflamation markers in COVID-19 patients and ischaemic heart disease
The purpose of the work to investigate the connection between hospital mortality and markers of systemic inflammation in COVID-19 patients with ischemic heart disease (IHD).Material and methods. The data of 52 patients’cases of diseases on COVID-19 with IHD who underwent inpatient treatment were analyzed. The first group included 40 patients who were discharged with recovery, and the second group included 12 patients who died. The degree of systemic inflammation syndrome in the selected groups of patients was estimated by the number of leukocytes and cellular composition of peripheral blood upon admission to the hospital, and based on the data received, the value of hematological integral indices was calculated.Results. It has been established that group II patients who died of cardiovascular complications connected with COVID-19 had significantly higher levels of systemic inflammatory response, which exhibits a significant increase in the total blood white blood cell content and increases in the percentage of neutrophils with a decrease in the percentage of lymphocytes and is substantially higher than the integrated haematological indices: leukocyte shift index, index of the ratio of neutrophils to lymphocytes and index of the ratio of neutrophils to monocytes. During the systemic inflammatory reaction, it has been observed that the inflammatory process aggravates the coronary atherosclerotic plaque making them more susceptible to rupture. Therefore, we can assume that existing IHD combined with an enhanced inflammatory response can lead to heart damage in patients infected with SARS-CoV- 2.Conclusion. Lymphocytopenia, excessive activation of the inflammatory cascade and heart damage are important features of COVID-19 disease and have high predictive value.
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