Researchers take a closer look at what COVID-19 does to the heart
By Thor Christensen, American Heart Association 线上电子游戏飞禽走兽
People hospitalized with COVID-19 may have an increased risk for heart damage, but not so much the type of inflammation previous research suggested, according to a new study.
Early in the pandemic, 几项研究表明，许多COVID-19幸存者经历了心脏损伤，即使他们没有潜在的心脏病，也没有病到需要住院的程度. 的 new study, published Friday in the American Heart Association journal 循环, 研究了病情最严重的COVID-19患者心脏损伤和炎症的性质和程度.
研究人员在2020年6月至2021年3月期间，在英国25家医院观察了342名高水平肌钙蛋白的COVID-19患者. 血液检查中肌钙蛋白水平升高是急性心肌损伤或心脏病发作的有力指标. Doctors routinely check troponin levels in people hospitalized for COVID-19.
Participants were compared with two control groups, one with 64 people hospitalized with COVID-19 who had normal troponin levels, and a second group of 113 people of a similar age, 性和心血管健康，但没有COVID-19或未住院的肌钙蛋白水平升高. 所有住院患者出院后28天内进行磁共振成像扫描. Non-hospitalized participants also received an MRI.
研究发现，61%的肌钙蛋白水平高的COVID-19住院患者患有心脏异常，包括心肌梗死疤痕, also known as a heart attack, or from microinfarction, which the study's lead author, 约翰·格林伍德, called "small areas of scar.这几乎是肌钙蛋白正常的住院COVID-19参与者(36%)和肌钙蛋白正常的非COVID-19参与者(31%)的两倍。.
But when it came to suspected myocarditis, 一种罕见的，有时是致命的心肌炎症，通常由病毒感染引起, researchers found the prevalence was 6.7% in participants with COVID-19 and elevated troponin, compared to 1.7% in those without. That's much lower than seen in previous studies, according to Greenwood, 他是英国利兹心血管和糖尿病研究所的心脏病学教授，也是利兹教学医院NHS信托的心脏病专家.
"Several smaller past studies raised a lot of concern about myocarditis. 但这项针对肌钙蛋白升高住院患者的更严格的全国性研究清楚地表明，这并不是病毒性心肌炎的主要症状, but more of a condition of infarction and microinfarction,他说. “这对临床医生来说是非常重要的信息，他们面临着试图理解为什么肌钙蛋白水平升高的挑战，这样他们就可以定制适当的治疗方案。."
格林伍德说，由于缺乏参与者住院前心脏线上娱乐电子游戏网站的数据和“幸存者偏见”，这项研究受到了限制," since the research focused only on patients who survived to hospital discharge. 格林伍德和他的同事计划在六个月时重复核磁共振扫描，对这一组进行更多的研究.
蒂姆Duong, 他是纽约市爱因斯坦医学院和蒙蒂菲奥里医学中心的放射学教授，他没有参与这项研究, noted that the study began before COVID-19 vaccines were available. Since the first COVID-19 vaccines became available in the U.S. in December 2020, hundreds of millions of doses have been administered nationwide, according to the Centers for Disease Control and Prevention.
“疫苗通常会降低疾病的严重程度，并减少本研究中报告的异常影像学结果,Duong说.
的 疾控中心建议 6个月及以上的每个人都应及时接种适合其年龄组的COVID疫苗.
"This is the first large, multi-hospital cardiac MRI study on the effects of COVID on the heart,Duong说. “这些重要发现将提高人们的认识，以便更好地监测有心脏损伤风险的COVID患者，并及时进行治疗, 如果需要, to prevent further cardiac issues."
他呼吁进行长期研究，以更好地了解“长冠状病毒”可能对心脏和其他器官的影响.
"Tens of millions of people have gotten sick from COVID, and we think it's causing multi-organ damage. 但在这一点上，没有人真正知道长期影响是什么。. “我们需要对患者进行多年的跟踪研究，这样我们才能预测问题并尽早治疗."
编者注:由于围绕冠状病毒的线上娱乐电子游戏网站迅速演变, the facts and advice presented in this story may have changed since publication. 访问的心.org for the latest coverage, 并向疾病控制和预防中心以及当地卫生官员咨询最新的指导意见.
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