Previous and First Detected Cardiovascular Diseases in Patients with New Coronavirus Pneumonia: Possible Mechanisms and Place in a Unified Prognostic Model.

Autor:	Blagova OV; The First I.M. Sechenov Moscow State Medical University (Sechenov University), Moscow, Russian Federation., Varionchik NV; The First I.M. Sechenov Moscow State Medical University (Sechenov University), Moscow, Russian Federation., Zaidenov VA; Moscow City Clinical Hospital No. 52, Moscow, Russian Federation., Savina PO; The First I.M. Sechenov Moscow State Medical University (Sechenov University), Moscow, Russian Federation., Sarkisova ND; The First I.M. Sechenov Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
Jazyk:	angličtina
Zdroj:	International archives of allergy and immunology [Int Arch Allergy Immunol] 2021; Vol. 182 (8), pp. 765-774. Date of Electronic Publication: 2021 May 19.
DOI:	10.1159/000515253
Abstrakt:	Purpose: The aim of this study is to evaluate the frequency of cardiac involvement in patients with coronavirus disease 2019 (COVID-19), possible immune mechanisms of myocardial injury, and the place of cardiovascular pathology among other prognostic factors. Methods: The study included 86 patients (48 male, 60.2 ± 16.6 years) with COVID-19. In addition to common investigation, examination of troponin T (n = 18) and anti-heart antibodies (AHA, n = 34) were used. The average hospital period was 14 [12; 18] days. Results: The incidence of cardiovascular disease and symptoms was 45.3%. Arrhythmias, heart failure, low-QRS voltage, repolarization disorders, and pericardial effusion were the typical for coronavirus cardiac injury. The level of AHA was increased in 73.5%. Significant (p < 0.05) correlations of AHA level with inflammatory activity, pneumonia, respiratory failure, cardiac symptoms, and death were found. D-dimer >0.5 μg/mL had a sensitivity of 79.2% and specificity of 60% in the prediction of cardiovascular manifestations. Cardiac failure was one of the causes of death in 3/8 patients (37.5%). Lethality in the presence of cardiovascular pathology was 17.9 versus 2.2% without it, p < 0.05. The most powerful prognostic model includes age, diabetes, oxygen therapy volume, maximum leukocyte level, C-reactive protein, and D-dimer (correlation coefficient 0.871, p < 0.001). The model with only age, diabetes, and cardiovascular disease included also had predictive power (correlation coefficient 0.568, p < 0.001). Conclusions: The cardiovascular pathology is frequent in patients with COVID-19 and strong correlates with the D-dimer. It indicates the high significance of prothrombotic and ischemic mechanisms. High AHA levels may reflect an inflammatory heart injury. The cardiovascular pathology is associated with higher lethality. (© 2021 The Author(s). Published by S. Karger AG, Basel.)
Databáze:	MEDLINE
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