伴或不伴血管钙化的新型冠状病毒肺炎危重症患者临床特征及转归的回顾性分析

目的分析伴或不伴血管钙化的新型冠状病毒肺炎(COVID-19)危重症患者临床特征及转归的差异。方法对2020年2月入住华中科技大学同济医学院附属同济医院重症监护室的COVID-19危重症患者进行回顾性分析。根据胸部CT表现,将患者分为血管钙化组和非血管钙化组,其中血管钙化组又分为主动脉钙化组、冠状动脉钙化组和同时钙化组(主动脉、冠状动脉均有钙化)。比较不同组别患者的临床特征及转归。结果与非血管钙化组相比,血管钙化组患者年龄偏大,合并高血压与冠心病比例更高,表现为更高的白细胞计数、中性粒细胞计数、C反应蛋白、球蛋白、乳酸脱氢酶、国际标准化比值、D-二聚体、肌酐、肌酸激酶同工酶、高敏肌钙蛋白、肌红蛋白、N末端B型脑钠肽原,较低的淋巴细胞计数、血小板计数、白蛋白、估算的肾小球滤过率,且死亡风险更高。与主动脉钙化组比较,冠状动脉钙化组和同时钙化组的转归更差。结论血管钙化特别是冠状动脉钙化可能是COVID-19危重症患者预后不良的危险因素。

Retrospective analysis of clinical characteristics and outcomes of coronavirus disease 2019 critically ill patients with or without vascular calcification

Aim To analyze the differences in clinical characteristics and outcomes of coronavirus disease 2019(COVID-19)critically ill patients with or without vascular calcification.Methods COVID-19 critically ill patients admitted to the intensive care unit of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology in February 2020 were analyzed retrospectively.According to the chest CT findings,the patients were divided into vascular calcification group and non-vascular calcification group.The vascular calcification group was further divided into aortic calcification group,coronary calcification group and simultaneous calcification group(both aorta and coronary artery calcification).The clinical characteristics and outcomes of patients were compared in different groups.Results Compared with the non-vascular calcification group,the patients in the vascular calcification group were older and had a higher proportion of hypertension and coronary heart disease,which showed higher levels of leukocyte count,neutrophil count,C-reactive protein,globulin,lactate dehydrogenase,international normalized ratio,D-dimer,creatinine,creatine kinase-MB,high-sensitivity cardiac troponin,myohemoglobin and N-terminal pro-B-type natriuretic peptide,lower levels of lymphocyte count,platelet count,albumin,estimated glomerular filtration rate,and higher risk of death.Compared with aortic calcification group,the outcomes of coronary calcification group and simultaneous calcification group were worse.Conclusion Vascular calcification,especially coronary artery calcification,may be a risk factor for poor prognosis in COVID-19 critically ill patients.