[Clinical characteristics and outcomes of 112 cardiovascular disease patients infected by 2019-nCoV]
- PMID: 32120458
- DOI: 10.3760/cma.j.cn112148-20200220-00105
[Clinical characteristics and outcomes of 112 cardiovascular disease patients infected by 2019-nCoV]
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 (0.34, 0.94)×109/L vs. 0.99 (0.71, 1.29)×109/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/m2 vs. 22.0 (20.0, 24.0) kg/m2，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> 25.0 kg/m2, 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.
目的： 研究心血管病（CVD）患者罹患新型冠状病毒肺炎（COVID-19）后的临床特点及转归。 方法： 回顾性分析2020年1月20日至2月15日入武汉协和医院西院的112例COVID-19合并CVD患者，按病情严重程度分为危重组（n=16）和普通组（n=96），观察随访至临床终点。观察指标包括全血细胞计数、C反应蛋白（CRP）、动脉血气分析、心肌损伤标志物、凝血功能、肝肾功能、电解质、降钙素原（PCT）、B型利钠肽（BNP）、血脂、肺部CT及病原学检测。 结果： 与普通组比较，危重组患者淋巴细胞计数[0.74（0.34，0.94）×109/L比0.99（0.71，1.29）×109/L，P=0.03]较低，CRP[106.98（81.57，135.76）mg/L比34.34（9.55，76.54）mg/L，P<0.001]和PCT[0.20（0.15，0.48）μg/L比0.11（0.06，0.20）μg/L，P<0.001]较高；危重组体重指数（BMI）明显高于普通组[25.5（23.0，27.5）kg/m2比22.0（20.0， 24.0）kg/m2，P=0.003]。112例患者中全因死亡17例（15.18%），治愈95例（84.82%）。死亡患者中，BMI>25.0 kg/m2患者占88.24%（15/17），明显高于治愈患者的18.95%（18/95，P<0.001）。和治愈患者比较，死亡患者乳酸水平[1.70（1.30，3.00）mmol/L比1.20（1.10，1.60）mmol/L，P<0.001]较高，氧合指数[130（102，415）比434（410，444），P<0.001]明显偏低。使用血管紧张素转换酶抑制剂(ACEI)/血管紧张素Ⅱ受体阻滞剂(ARB)的患者比例无论在危重组与普通组间还是在死亡与治愈患者间比较，差异均无统计学意义（P均>0.05）。 结论： COVID-19合并CVD病情重病死率较高。危重患者淋巴细胞偏低，危重患者和死亡患者BMI值偏高。ACEI/ARB不影响COVID-19合并CVD患者的发病率和病死率。加剧患者死亡的原因可能与炎症反应、乳酸堆积酸中毒以及恶性心血管事件有关。.
Keywords: COVID-19; Cardiovascular diseases; Treatment outcomeTrial Registration： Chinese Clinical Trial Registry， ChiCTR2000029865.
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