PDF(Pubmed)
Abstract：
Coronary artery disease (CAD) is considered an independent risk factor for COVID-19. However, no study has specifically examined the clinical manifestations and outcomes of COVID-19 in patients with ischemic heart disease (IHD).
In a retrospective case-control study between 20 March 2020 to 20 May 2020, the medical record of 1611 patients with laboratory-confirmed SARS-CoV-2 infection was reviewed. IHD was defined as a history of an abnormal coronary angiography, coronary angioplasty, coronary artery bypass graft (CABG), or chronic stable angina. Demographic data, past medical history, drug history, symptoms, vital signs, laboratory findings, outcome, and death were investigated from medical records.
1518 Patients (882 men (58.1%)) with a mean age of 59.3 ± 15.5 years were included in the study. Patients with IHD (n = 300) were significantly less likely to have fever (OR: 0.170, 95% CI: 0.34-0.81, P < 0.001), and chills (OR: 0.74, 95% CI: 0.45-0.91, P < 0.001). Patients with IHD were 1.57 times more likely to have hypoxia (83.3% vs. 76%, OR: 1.57, 95% CI: 1.13-2.19, P = 0.007). There was no significant difference in terms of WBC, platelets, lymphocytes, LDH, AST, ALT, and CRP between the two groups (P > 0.05). After adjusting for demographic characteristics, comorbidities and vital signs, the risk factors for mortality of these patients were older age (OR: 1.04 and 1.07) and cancer (OR: 1.03, and 1.11) in both groups. In addition, in the patients without IHD, diabetes mellitus (OR: 1.50), CKD (OR: 1.21) and chronic respiratory diseases (OR: 1.48) have increased the odds of mortality. In addition, the use of anticoagulants (OR: 2.77) and calcium channel blockers (OR: 2.00) has increased the odds of mortality in two groups.
In comparison with non-IHD, the symptoms of SARS-CoV-2 infection such as fever, chills and diarrhea were less common among patients with a history of IHD. Also, older age, and comorbidities (including cancer, diabetes mellitus, CKD and chronic obstructive respiratory diseases) have been associated with a higher risk of mortality in patients with IHD. In addition, the use of anticoagulants and calcium channel blockers has increased the chance of death in two groups without and with IHD.
In a retrospective case-control study between 20 March 2020 to 20 May 2020, the medical record of 1611 patients with laboratory-confirmed SARS-CoV-2 infection was reviewed. IHD was defined as a history of an abnormal coronary angiography, coronary angioplasty, coronary artery bypass graft (CABG), or chronic stable angina. Demographic data, past medical history, drug history, symptoms, vital signs, laboratory findings, outcome, and death were investigated from medical records.
1518 Patients (882 men (58.1%)) with a mean age of 59.3 ± 15.5 years were included in the study. Patients with IHD (n = 300) were significantly less likely to have fever (OR: 0.170, 95% CI: 0.34-0.81, P < 0.001), and chills (OR: 0.74, 95% CI: 0.45-0.91, P < 0.001). Patients with IHD were 1.57 times more likely to have hypoxia (83.3% vs. 76%, OR: 1.57, 95% CI: 1.13-2.19, P = 0.007). There was no significant difference in terms of WBC, platelets, lymphocytes, LDH, AST, ALT, and CRP between the two groups (P > 0.05). After adjusting for demographic characteristics, comorbidities and vital signs, the risk factors for mortality of these patients were older age (OR: 1.04 and 1.07) and cancer (OR: 1.03, and 1.11) in both groups. In addition, in the patients without IHD, diabetes mellitus (OR: 1.50), CKD (OR: 1.21) and chronic respiratory diseases (OR: 1.48) have increased the odds of mortality. In addition, the use of anticoagulants (OR: 2.77) and calcium channel blockers (OR: 2.00) has increased the odds of mortality in two groups.
In comparison with non-IHD, the symptoms of SARS-CoV-2 infection such as fever, chills and diarrhea were less common among patients with a history of IHD. Also, older age, and comorbidities (including cancer, diabetes mellitus, CKD and chronic obstructive respiratory diseases) have been associated with a higher risk of mortality in patients with IHD. In addition, the use of anticoagulants and calcium channel blockers has increased the chance of death in two groups without and with IHD.
摘要：
背景：冠状动脉疾病（CAD）被认为是COVID-19的独立危险因素。然而,没有一项研究专门检查了缺血性心脏病(IHD)患者中COVID-19的临床表现和结局.
方法：在2020年3月20日至2020年5月20日的一项回顾性病例对照研究中，回顾了1611例经实验室确诊的SARS-CoV-2感染患者的病历。IHD被定义为冠状动脉造影异常的病史，冠状动脉成形术,冠状动脉旁路移植术(CABG),或者慢性稳定型心绞痛.人口统计数据,既往病史,药物史,症状,生命体征,实验室发现,结果,从医疗记录中调查死亡。
结果：1518名患者（882名男性（58.1%）），平均年龄为59.3±15.5岁。IHD患者(n=300)发热的可能性显著降低(OR:0.170,95%CI:0.34-0.81,P<0.001),寒战(OR:0.74,95%CI:0.45-0.91,P<0.001)。IHD患者缺氧的可能性是1.57倍(83.3%vs.76%,OR：1.57，95%CI：1.13-2.19，P=0.007）。WBC无显著差异,血小板,淋巴细胞，LDH,AST,ALT,两组CRP水平比较(P>0.05)。在调整了人口统计特征后，合并症和生命体征，两组患者死亡的危险因素为年龄较大(OR:1.04和1.07)和癌症(OR:1.03和1.11).此外,在没有IHD的患者中，糖尿病（OR：1.50），CKD（OR：1.21）和慢性呼吸系统疾病（OR：1.48）增加了死亡率。此外,抗凝剂(OR:2.77)和钙通道阻滞剂(OR:2.00)的使用增加了两组的死亡率.
结论：与非IHD相比，SARS-CoV-2感染的症状，如发烧，在有IHD病史的患者中,寒战和腹泻较少见.此外，年龄较大,和合并症（包括癌症，糖尿病,CKD和慢性阻塞性呼吸系统疾病）与IHD患者的较高死亡率相关。此外,抗凝剂和钙通道阻滞剂的使用增加了两组无IHD患者和有IHD患者的死亡几率.
方法：在2020年3月20日至2020年5月20日的一项回顾性病例对照研究中，回顾了1611例经实验室确诊的SARS-CoV-2感染患者的病历。IHD被定义为冠状动脉造影异常的病史，冠状动脉成形术,冠状动脉旁路移植术(CABG),或者慢性稳定型心绞痛.人口统计数据,既往病史,药物史,症状,生命体征,实验室发现,结果,从医疗记录中调查死亡。
结果：1518名患者（882名男性（58.1%）），平均年龄为59.3±15.5岁。IHD患者(n=300)发热的可能性显著降低(OR:0.170,95%CI:0.34-0.81,P<0.001),寒战(OR:0.74,95%CI:0.45-0.91,P<0.001)。IHD患者缺氧的可能性是1.57倍(83.3%vs.76%,OR：1.57，95%CI：1.13-2.19，P=0.007）。WBC无显著差异,血小板,淋巴细胞，LDH,AST,ALT,两组CRP水平比较(P>0.05)。在调整了人口统计特征后，合并症和生命体征，两组患者死亡的危险因素为年龄较大(OR:1.04和1.07)和癌症(OR:1.03和1.11).此外,在没有IHD的患者中，糖尿病（OR：1.50），CKD（OR：1.21）和慢性呼吸系统疾病（OR：1.48）增加了死亡率。此外,抗凝剂(OR:2.77)和钙通道阻滞剂(OR:2.00)的使用增加了两组的死亡率.
结论：与非IHD相比，SARS-CoV-2感染的症状，如发烧，在有IHD病史的患者中,寒战和腹泻较少见.此外，年龄较大,和合并症（包括癌症，糖尿病,CKD和慢性阻塞性呼吸系统疾病）与IHD患者的较高死亡率相关。此外,抗凝剂和钙通道阻滞剂的使用增加了两组无IHD患者和有IHD患者的死亡几率.
