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 #x3c; 0.05) correlations of AHA level with inflammatory activity, pneumonia, respiratory failure, cardiac symptoms, and death were found. D-dimer #x3e;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 #x3c; 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 #x3c; 0.001). The model with only age, diabetes, and cardiovascular disease included also had predictive power (correlation coefficient 0.568, p #x3c; 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.
Int Arch Allergy Immunol

中文翻译：

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新冠肺炎患者既往和首次发现的心血管疾病：可能的机制和在统一预后模型中的位置

目的：本研究的目的是评估 2019 冠状病毒病（COVID-19）患者心脏受累的频率、心肌损伤的可能免疫机制以及心血管病理在其他预后因素中的地位。方法：该研究包括 86 名 COVID-19 患者（48 名男性，60.2 ± 16.6 岁）。除了常见的调查外，还使用了肌钙蛋白 T（ n = 18）和抗心脏抗体（AHA， n = 34）的检查。平均住院时间为 14 [12; 18]天。结果：心血管疾病和症状的发生率为45.3%。心律失常、心力衰竭、低 QRS 电压、复极障碍和心包积液是冠状病毒心脏损伤的典型表现。AHA 水平增加了 73.5%。发现 AHA 水平与炎症活动、肺炎、呼吸衰竭、心脏症状和死亡之间存在显着 ( p #x3c; 0.05) 相关性。D-二聚体#x3e;0.5 μg/mL 在预测心血管表现方面的敏感性为 79.2%，特异性为 60%。心力衰竭是 3/8 患者 (37.5%) 的死亡原因之一。存在心血管病变时的致死率为 17.9%，无时为 2.2%，p#x3c; 0.05。最强大的预后模型包括年龄、糖尿病、氧疗量、最大白细胞水平、C 反应蛋白和 D-二聚体（相关系数 0.871，p #x3c；0.001）。仅包含年龄、糖尿病和心血管疾病的模型也具有预测能力（相关系数 0.568，p #x3c；0.001）。结论：心血管病理在 COVID-19 患者中很常见，并且与 D-二聚体密切相关。它表明促血栓形成和缺血机制的重要性。高 AHA 水平可能反映了炎症性心脏损伤。心血管病理与更高的致死率有关。
Int Arch 过敏免疫