[Analysis of myocardial injury in patients with COVID-19 and association between concomitant cardiovascular diseases and severity of COVID-19].
Identifieur interne : 000125 ( PubMed/Checkpoint ); précédent : 000124; suivant : 000126[Analysis of myocardial injury in patients with COVID-19 and association between concomitant cardiovascular diseases and severity of COVID-19].
Auteurs : C. Chen [République populaire de Chine] ; C. Chen [République populaire de Chine] ; J T Yan [République populaire de Chine] ; N. Zhou [République populaire de Chine] ; J P Zhao [République populaire de Chine] ; D W Wang [République populaire de Chine]Source :
- Zhonghua xin xue guan bing za zhi [ 0253-3758 ] ; 2020.
Abstract
Objective: To evaluate the cardiovascular damage of patients with COVID-19, and determine the correlation of serum N-terminal pro B-type natriuretic peptide (NT-proBNP) and cardiac troponin-I (cTnI) with the severity of COVID-19, and the impact of concomitant cardiovascular disease on severity of COVID-19 was also evaluated. Methods: A cross-sectional study was designed on 150 consecutive patients with COVID-19 in the fever clinic of Tongji Hospital in Wuhan from January to February in 2020, including 126 mild cases and 24 cases in critical care. Both univariate and multivariate logistic regression were used to analyze the correlation of past medical history including hypertension, diabetes and coronary heart disease (CHD) , as well as the levels of serum NT-proBNP and cTnI to the disease severity of COVID-19 patients. Results: Age, hypersensitive C-reactive protein(hs-CRP) and serum creatinine levels of the patients were higher in critical care cases than in mild cases(all P<0.05). Prevalence of male, elevated NT-proBNP and cTnI, hypertension and coronary heart disease were significantly higher in critical cases care patients than in the mild cases(all P<0.05). Univariate logistic regression analysis showed that age, male, elevated NT-proBNP, elevated cTnI, elevated hs-CRP, elevated serum creatinine, hypertension, and CHD were significantly correlated with critical disease status(all P<0.05). Multivariate logistic regression analysis showed that elevated cTnI(OR=26.909, 95%CI 4.086-177.226, P=0.001) and CHD (OR=16.609, 95%CI 2.288-120.577, P=0.005) were the independent risk factors of critical disease status. Conclusions: COVID-19 can significantly affect the heart function and lead to myocardial injury. The past medical history of CHD and increased level of cTnI are two independent determinants of clinical disease status in patients with COVID-19.
DOI: 10.3760/cma.j.cn112148-20200225-00123
PubMed: 32141280
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Chen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Tongji Hospital, 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>Department of Cardiology, Tongji Hospital, 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="Yan, J T" sort="Yan, J T" uniqKey="Yan J" first="J T" last="Yan">J T Yan</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Tongji Hospital, 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>Department of Cardiology, Tongji Hospital, 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="Zhou, N" sort="Zhou, N" uniqKey="Zhou N" first="N" last="Zhou">N. Zhou</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Tongji Hospital, 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>Department of Cardiology, Tongji Hospital, 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="Zhao, J P" sort="Zhao, J P" uniqKey="Zhao J" first="J P" last="Zhao">J P Zhao</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Tongji Hospital, 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>Department of Cardiology, Tongji Hospital, 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="Wang, D W" sort="Wang, D W" uniqKey="Wang D" first="D W" last="Wang">D W Wang</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Tongji Hospital, 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>Department of Cardiology, Tongji Hospital, 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></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32141280</idno><idno type="pmid">32141280</idno><idno type="doi">10.3760/cma.j.cn112148-20200225-00123</idno><idno type="wicri:Area/PubMed/Corpus">000785</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000785</idno><idno type="wicri:Area/PubMed/Curation">000785</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000785</idno><idno type="wicri:Area/PubMed/Checkpoint">000125</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">000125</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">[Analysis of myocardial injury in patients with COVID-19 and association between concomitant cardiovascular diseases and severity of COVID-19].</title><author><name sortKey="Chen, C" sort="Chen, C" uniqKey="Chen C" first="C" last="Chen">C. Chen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Tongji Hospital, 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>Department of Cardiology, Tongji Hospital, 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="Chen, C" sort="Chen, C" uniqKey="Chen C" first="C" last="Chen">C. Chen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Tongji Hospital, 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>Department of Cardiology, Tongji Hospital, 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="Yan, J T" sort="Yan, J T" uniqKey="Yan J" first="J T" last="Yan">J T Yan</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Tongji Hospital, 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>Department of Cardiology, Tongji Hospital, 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="Zhou, N" sort="Zhou, N" uniqKey="Zhou N" first="N" last="Zhou">N. Zhou</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Tongji Hospital, 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>Department of Cardiology, Tongji Hospital, 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="Zhao, J P" sort="Zhao, J P" uniqKey="Zhao J" first="J P" last="Zhao">J P Zhao</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Tongji Hospital, 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>Department of Cardiology, Tongji Hospital, 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="Wang, D W" sort="Wang, D W" uniqKey="Wang D" first="D W" last="Wang">D W Wang</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Tongji Hospital, 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>Department of Cardiology, Tongji Hospital, 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></analytic><series><title level="j">Zhonghua xin xue guan bing za zhi</title><idno type="ISSN">0253-3758</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><b>Objective:</b> To evaluate the cardiovascular damage of patients with COVID-19, and determine the correlation of serum N-terminal pro B-type natriuretic peptide (NT-proBNP) and cardiac troponin-I (cTnI) with the severity of COVID-19, and the impact of concomitant cardiovascular disease on severity of COVID-19 was also evaluated. <b>Methods:</b> A cross-sectional study was designed on 150 consecutive patients with COVID-19 in the fever clinic of Tongji Hospital in Wuhan from January to February in 2020, including 126 mild cases and 24 cases in critical care. Both univariate and multivariate logistic regression were used to analyze the correlation of past medical history including hypertension, diabetes and coronary heart disease (CHD) , as well as the levels of serum NT-proBNP and cTnI to the disease severity of COVID-19 patients. <b>Results:</b> Age, hypersensitive C-reactive protein(hs-CRP) and serum creatinine levels of the patients were higher in critical care cases than in mild cases(all <i>P</i><0.05). Prevalence of male, elevated NT-proBNP and cTnI, hypertension and coronary heart disease were significantly higher in critical cases care patients than in the mild cases(all <i>P</i><0.05). Univariate logistic regression analysis showed that age, male, elevated NT-proBNP, elevated cTnI, elevated hs-CRP, elevated serum creatinine, hypertension, and CHD were significantly correlated with critical disease status(all <i>P</i><0.05). Multivariate logistic regression analysis showed that elevated cTnI(<i>OR</i>=26.909, 95%<i>CI</i> 4.086-177.226, <i>P</i>=0.001) and CHD (<i>OR</i>=16.609, 95%<i>CI</i> 2.288-120.577, <i>P</i>=0.005) were the independent risk factors of critical disease status. <b>Conclusions:</b> COVID-19 can significantly affect the heart function and lead to myocardial injury. The past medical history of CHD and increased level of cTnI are two independent determinants of clinical disease status in patients with COVID-19.</div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32141280</PMID><DateRevised><Year>2020</Year><Month>03</Month><Day>06</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">0253-3758</ISSN><JournalIssue CitedMedium="Print"><Volume>48</Volume><Issue>0</Issue><PubDate><Year>2020</Year><Month>Mar</Month><Day>06</Day></PubDate></JournalIssue><Title>Zhonghua xin xue guan bing za zhi</Title><ISOAbbreviation>Zhonghua Xin Xue Guan Bing Za Zhi</ISOAbbreviation></Journal><ArticleTitle>[Analysis of myocardial injury in patients with COVID-19 and association between concomitant cardiovascular diseases and severity of COVID-19].</ArticleTitle><Pagination><MedlinePgn>E008</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.3760/cma.j.cn112148-20200225-00123</ELocationID><Abstract><AbstractText><b>Objective:</b> To evaluate the cardiovascular damage of patients with COVID-19, and determine the correlation of serum N-terminal pro B-type natriuretic peptide (NT-proBNP) and cardiac troponin-I (cTnI) with the severity of COVID-19, and the impact of concomitant cardiovascular disease on severity of COVID-19 was also evaluated. <b>Methods:</b> A cross-sectional study was designed on 150 consecutive patients with COVID-19 in the fever clinic of Tongji Hospital in Wuhan from January to February in 2020, including 126 mild cases and 24 cases in critical care. Both univariate and multivariate logistic regression were used to analyze the correlation of past medical history including hypertension, diabetes and coronary heart disease (CHD) , as well as the levels of serum NT-proBNP and cTnI to the disease severity of COVID-19 patients. <b>Results:</b> Age, hypersensitive C-reactive protein(hs-CRP) and serum creatinine levels of the patients were higher in critical care cases than in mild cases(all <i>P</i><0.05). Prevalence of male, elevated NT-proBNP and cTnI, hypertension and coronary heart disease were significantly higher in critical cases care patients than in the mild cases(all <i>P</i><0.05). Univariate logistic regression analysis showed that age, male, elevated NT-proBNP, elevated cTnI, elevated hs-CRP, elevated serum creatinine, hypertension, and CHD were significantly correlated with critical disease status(all <i>P</i><0.05). Multivariate logistic regression analysis showed that elevated cTnI(<i>OR</i>=26.909, 95%<i>CI</i> 4.086-177.226, <i>P</i>=0.001) and CHD (<i>OR</i>=16.609, 95%<i>CI</i> 2.288-120.577, <i>P</i>=0.005) were the independent risk factors of critical disease status. <b>Conclusions:</b> COVID-19 can significantly affect the heart function and lead to myocardial injury. The past medical history of CHD and increased level of cTnI are two independent determinants of clinical disease status in patients with COVID-19.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>C</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>C</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yan</LastName><ForeName>J T</ForeName><Initials>JT</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhou</LastName><ForeName>N</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhao</LastName><ForeName>J P</ForeName><Initials>JP</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>D W</ForeName><Initials>DW</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.</Affiliation></AffiliationInfo></Author></AuthorList><Language>chi</Language><GrantList CompleteYN="Y"><Grant><GrantID>2019CR207</GrantID><Agency>Fulminant Myocaditis Program of Tongji Hospital</Agency><Country></Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D004740">English Abstract</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>03</Month><Day>06</Day></ArticleDate></Article><MedlineJournalInfo><Country>China</Country><MedlineTA>Zhonghua Xin Xue Guan Bing Za Zhi</MedlineTA><NlmUniqueID>7910682</NlmUniqueID><ISSNLinking>0253-3758</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><OtherAbstract Type="Publisher" Language="chi"><AbstractText><b>目的：</b> 分析新型冠状病毒肺炎（COVID-19）危重症患者心肌损伤及患有心血管基础疾病的情况。 <b>方法：</b> 回顾性分析2019年1月至2020年2月华中科技大学同济医学院附属同济医院发热病房住院的咽拭子样本2019新型冠状病毒（2019-nCoV）核酸检测阳性的COVID-19患者的临床资料。根据临床分型将患者分为危重型组和非危重症型（包括重症型）组。通过电子病历系统收集入选者的一般临床资料以及患有基础疾病的情况。收集入选患者住院期间实验室检查结果，包括血清N末端B型利钠肽原（NT-proBNP）、心肌肌钙蛋白I（cTnI）、超敏C反应蛋白（hs-CRP）和血肌酐的最高值，血红蛋白的最低值。采用单因素和多因素logistic回归模型分析COVID-19危重症型的相关因素。 <b>结果：</b> 共入选COVID-19患者150例，其中危重症型患者24例（危重型组）、非危重症型患者126例（非危重型组），年龄（59±16）岁，男性84例（56%）。危重型组患者的年龄、hs-CRP和血肌酐水平均高于非危重型组（<i>P</i>均<0.05）。危重型组患者中男性、NT-proBNP升高、cTnI升高以及患有高血压、既往冠心病史的比例均高于非危重型组（<i>P</i>均<0.05）。而且，危重型组患者NT-proBNP和cTnI水平均明显高于非危重症组（<i>P</i>均<0.05）。两组患者患有糖尿病的比例及血红蛋白水平差异均无统计学意义（<i>P</i>均>0.05）。单因素logistic回归分析结果显示，年龄、男性、NT-proBNP升高、cTnI升高、hs-CRP升高、血肌酐升高、患有高血压、既往冠心病史是COVID-19危重型的相关因素（<i>P</i>均<0.05）。多因素logistic回归分析结果显示，cTnI升高（<i>OR</i>=26.909，95%<i>CI</i> 4.086~177.226，<i>P</i>=0.001）、既往冠心病史（<i>OR</i>=16.609，95%<i>CI</i> 2.288~120.577，<i>P</i>=0.005）是COVID-19危重型的独立相关因素。 <b>结论：</b> 心肌损伤及既往冠心病史是COVID-19危重症患者重要的临床特征。.</AbstractText></OtherAbstract><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Cardiovascular diseases</Keyword><Keyword MajorTopicYN="N">Critical care</Keyword><Keyword MajorTopicYN="N">Heart injuries</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>3</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>3</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>3</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32141280</ArticleId><ArticleId IdType="doi">10.3760/cma.j.cn112148-20200225-00123</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>République populaire de Chine</li></country><region><li>Hubei</li></region><settlement><li>Wuhan</li></settlement></list><tree><country name="République populaire de Chine"><region name="Hubei"><name sortKey="Chen, C" sort="Chen, C" uniqKey="Chen C" first="C" last="Chen">C. Chen</name></region><name sortKey="Chen, C" sort="Chen, C" uniqKey="Chen C" first="C" last="Chen">C. Chen</name><name sortKey="Wang, D W" sort="Wang, D W" uniqKey="Wang D" first="D W" last="Wang">D W Wang</name><name sortKey="Yan, J T" sort="Yan, J T" uniqKey="Yan J" first="J T" last="Yan">J T Yan</name><name sortKey="Zhao, J P" sort="Zhao, J P" uniqKey="Zhao J" first="J P" last="Zhao">J P Zhao</name><name sortKey="Zhou, N" sort="Zhou, N" uniqKey="Zhou N" first="N" last="Zhou">N. Zhou</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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