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[Clinical characteristics and outcomes of 112 cardiovascular disease patients infected by 2019-nCoV].

Identifieur interne : 000109 ( Main/Exploration ); précédent : 000108; suivant : 000110

[Clinical characteristics and outcomes of 112 cardiovascular disease patients infected by 2019-nCoV].

Auteurs : Y D Peng [République populaire de Chine] ; K. Meng [République populaire de Chine] ; H Q Guan [République populaire de Chine] ; L. Leng [République populaire de Chine] ; R R Zhu [République populaire de Chine] ; B Y Wang [République populaire de Chine] ; M A He [République populaire de Chine] ; L X Cheng [République populaire de Chine] ; K. Huang [République populaire de Chine] ; Q T Zeng [République populaire de Chine]

Source :

RBID : pubmed:32120458

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.

DOI: 10.3760/cma.j.cn112148-20200220-00105
PubMed: 32120458


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<nlm:affiliation>School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.</nlm:affiliation>
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<wicri:regionArea>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022</wicri:regionArea>
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<nlm:affiliation>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.</nlm:affiliation>
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<name sortKey="Peng, Y D" sort="Peng, Y D" uniqKey="Peng Y" first="Y D" last="Peng">Y D Peng</name>
<affiliation wicri:level="1">
<nlm:affiliation>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022</wicri:regionArea>
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<settlement type="city">Wuhan</settlement>
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<name sortKey="Meng, K" sort="Meng, K" uniqKey="Meng K" first="K" last="Meng">K. Meng</name>
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<nlm:affiliation>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022</wicri:regionArea>
<placeName>
<settlement type="city">Wuhan</settlement>
<region type="région">Hubei</region>
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<name sortKey="Guan, H Q" sort="Guan, H Q" uniqKey="Guan H" first="H Q" last="Guan">H Q Guan</name>
<affiliation wicri:level="1">
<nlm:affiliation>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022</wicri:regionArea>
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<settlement type="city">Wuhan</settlement>
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<name sortKey="Leng, L" sort="Leng, L" uniqKey="Leng L" first="L" last="Leng">L. Leng</name>
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<nlm:affiliation>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022</wicri:regionArea>
<placeName>
<settlement type="city">Wuhan</settlement>
<region type="région">Hubei</region>
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<name sortKey="Zhu, R R" sort="Zhu, R R" uniqKey="Zhu R" first="R R" last="Zhu">R R Zhu</name>
<affiliation wicri:level="1">
<nlm:affiliation>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022</wicri:regionArea>
<placeName>
<settlement type="city">Wuhan</settlement>
<region type="région">Hubei</region>
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<name sortKey="Wang, B Y" sort="Wang, B Y" uniqKey="Wang B" first="B Y" last="Wang">B Y Wang</name>
<affiliation wicri:level="1">
<nlm:affiliation>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022</wicri:regionArea>
<placeName>
<settlement type="city">Wuhan</settlement>
<region type="région">Hubei</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="He, M A" sort="He, M A" uniqKey="He M" first="M A" last="He">M A He</name>
<affiliation wicri:level="1">
<nlm:affiliation>School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030</wicri:regionArea>
<placeName>
<settlement type="city">Wuhan</settlement>
<region type="région">Hubei</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Cheng, L X" sort="Cheng, L X" uniqKey="Cheng L" first="L X" last="Cheng">L X Cheng</name>
<affiliation wicri:level="1">
<nlm:affiliation>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022</wicri:regionArea>
<placeName>
<settlement type="city">Wuhan</settlement>
<region type="région">Hubei</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Huang, K" sort="Huang, K" uniqKey="Huang K" first="K" last="Huang">K. Huang</name>
<affiliation wicri:level="1">
<nlm:affiliation>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022</wicri:regionArea>
<placeName>
<settlement type="city">Wuhan</settlement>
<region type="région">Hubei</region>
</placeName>
</affiliation>
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<name sortKey="Zeng, Q T" sort="Zeng, Q T" uniqKey="Zeng Q" first="Q T" last="Zeng">Q T Zeng</name>
<affiliation wicri:level="1">
<nlm:affiliation>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.</nlm:affiliation>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Institute of Cardiovascular Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022</wicri:regionArea>
<placeName>
<settlement type="city">Wuhan</settlement>
<region type="région">Hubei</region>
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<title level="j">Zhonghua xin xue guan bing za zhi</title>
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<front>
<div type="abstract" xml:lang="en">
<b>Objective:</b>
To explore the clinical characteristics and prognosis of the new coronavirus 2019-nCoV patients combined with cardiovascular disease (CVD).
<b>Methods:</b>
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,
<i>n</i>
=16) and general group (
<i>n</i>
=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.
<b>Results:</b>
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,
<i>P</i>
=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,
<i>P</i>
<0.001) and PCT (0.20 (0.15,0.48) μg/L vs. 0.11 (0.06,0.20)μg/L,
<i>P</i>
<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),
<i>P</i>
=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),
<i>P</i>
<0.001). Compared with the survived patients, oxygenation index (130 (102, 415) vs. 434 (410, 444),
<i>P</i>
<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,
<i>P</i>
<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
<i>P</i>
>0.05).
<b>Conclusion:</b>
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.</div>
</front>
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<li>République populaire de Chine</li>
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<country name="République populaire de Chine">
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<name sortKey="Peng, Y D" sort="Peng, Y D" uniqKey="Peng Y" first="Y D" last="Peng">Y D Peng</name>
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<name sortKey="Cheng, L X" sort="Cheng, L X" uniqKey="Cheng L" first="L X" last="Cheng">L X Cheng</name>
<name sortKey="Guan, H Q" sort="Guan, H Q" uniqKey="Guan H" first="H Q" last="Guan">H Q Guan</name>
<name sortKey="He, M A" sort="He, M A" uniqKey="He M" first="M A" last="He">M A He</name>
<name sortKey="Huang, K" sort="Huang, K" uniqKey="Huang K" first="K" last="Huang">K. Huang</name>
<name sortKey="Leng, L" sort="Leng, L" uniqKey="Leng L" first="L" last="Leng">L. Leng</name>
<name sortKey="Meng, K" sort="Meng, K" uniqKey="Meng K" first="K" last="Meng">K. Meng</name>
<name sortKey="Wang, B Y" sort="Wang, B Y" uniqKey="Wang B" first="B Y" last="Wang">B Y Wang</name>
<name sortKey="Zeng, Q T" sort="Zeng, Q T" uniqKey="Zeng Q" first="Q T" last="Zeng">Q T Zeng</name>
<name sortKey="Zhu, R R" sort="Zhu, R R" uniqKey="Zhu R" first="R R" last="Zhu">R R Zhu</name>
</country>
</tree>
</affiliations>
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}}

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HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i   -Sk "pubmed:32120458" \
       | HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd   \
       | NlmPubMed2Wicri -a CovidV2 

Wicri

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