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ʻOiai ʻo COVID ka lōʻihi e paʻa ana i nā mea pohihihi he nui, ua ʻike nā mea noiʻi i nā hōʻailona i nā hōʻailona cardiac maʻamau i kēia mau maʻi, e hōʻike ana i ka hoʻomau mau ʻana he mea uʻi.
I loko o kahi cohort o 346 mau mea maʻi maʻi COVID-19 ma mua, ʻo ka hapa nui o lākou i noho maʻamau ma hope o ka median o kahi o 4 mau mahina, ʻoi aku ka nui o ka piʻi ʻana o nā biomarkers o ka maʻi puʻuwai a me ka hōʻeha puʻuwai a i ʻole ka dysfunction.
Akā he nui nā hōʻailona o nā pilikia puʻuwai subclinical, hōʻike iā Valentina O. Puntmann, MD, University Hospital Frankfurt, Kelemānia, a me kāna mau hoa hana ma Nature Medicine.
Hoʻohālikelike ʻia i nā kaohi ʻole, ua ʻoi aku ka kiʻekiʻe o ka maʻi maʻi COVID i ke koko diastolic kiʻekiʻe, hoʻonui nui ʻia ka maʻi myocardial non-ischemic ma muli o ka hoʻonui ʻana o ka gadolinium, ʻike ʻia ka pericardial effusion pili ʻole hemodynamically, a me ka effusion pericardial.<0,001). <0.001).
Eia kekahi, ʻo 73% o nā maʻi maʻi COVID-19 me nā hōʻailona puʻuwai i loaʻa i nā waiwai palapala kiʻekiʻe o ka cardiac MRI (CMR) ma mua o nā poʻe asymptomatic, e hōʻike ana i ka ʻeha myocardial diffuse a me ka hōʻiliʻili nui ʻana o ka hoʻohālikelike pericardial.
"He maikaʻi loa ka mea a mākou e ʻike nei," i haʻi aku ai ʻo Puntmann iā MedPage Today."He mau maʻi maʻamau kēia ma mua."
Ma ka hoʻohālikelike ʻana i ka mea i manaʻo mau ʻia he pilikia puʻuwai me COVID-19, hāʻawi kēia mau hopena i ka ʻike e ʻoi aku ka maʻi o nā maʻi me nā pilikia naʻau mua i ka haukapila me nā maʻi koʻikoʻi a me nā hopena.
Ua aʻo ka pūʻulu o Puntman i ka poʻe me ka pilikia ʻole o ka puʻuwai e hoʻāʻo e hoʻomaopopo i ka hopena o COVID-19 ponoʻī, me ka hoʻohana ʻana i nā kiʻi noiʻi MRI o nā mea maʻi i kiʻi ʻia i kā lākou mau keʻena ma o nā kauka ʻohana, nā kikowaena mana olakino, nā mea hoʻolaha i hāʻawi ʻia e nā mea maʻi ma ka pūnaewele.Nā hui a me nā pūnaewele..
Ua ʻōlelo ʻo Puntmann, ʻoiai he pūʻulu koho kēia o nā mea maʻi ʻaʻole i hōʻike maʻamau i nā hihia maʻalahi o COVID-19, ʻaʻole ia he mea maʻamau no kēia mau maʻi e ʻimi i nā pane i kā lākou mau hōʻailona.
Hōʻike ka ʻike noiʻi Federal he 19 pakeneka o nā pākeke ʻAmelika i loaʻa i ka maʻi COVID i loaʻa nā hōʻailona no 3 mau mahina a ʻoi aku paha ma hope o ka maʻi.Ma ke aʻo ʻana i kēia manawa, nānā ka hahai ʻana i ka awelika o 11 mau mahina ma hope o ka maʻi COVID-19 i hōʻike i nā hōʻailona puʻuwai mau i 57% o nā mea komo.ʻO ka poʻe i hoʻomau i ka hōʻailona ua ʻoi aku ka nui o ka edema myocardial ma mua o ka poʻe i hoʻōla a ʻaʻole loaʻa nā hōʻailona (T2 37.9 vs 37.4 a me 37.5 ms, P = 0.04).
"ʻO ke komo ʻana o ka naʻau he ʻāpana koʻikoʻi o nā hōʻike lōʻihi o COVID - no laila dyspnea, hoʻoikaika ʻole, tachycardia," wahi a Pontman i kahi ninaninau.
Ua hoʻoholo kāna hui ʻo nā hōʻailona cardiac a lākou i ʻike ai ua "pili ʻia me kahi maʻi inflammatory subclinical o ka puʻuwai, hiki ke wehewehe, ma ka liʻiliʻi loa, ke kumu pathophysiological o nā hōʻailona cardiac mau.ʻO ka mea nui, ʻo ka hōʻeha myocardial koʻikoʻi a i ʻole ka maʻi puʻuwai kino ʻaʻole ia he kūlana mua a ʻaʻole kūpono nā hōʻailona i ka wehewehe maʻamau o ka myocarditis viral.
Ua kuhikuhi ʻo Cardiologist a me ka mea maʻi maʻi COVID lōʻihi ʻo Alice A. Perlowski, MD, i nā hopena koʻikoʻi koʻikoʻi ma o ka tweeting: "Ke hōʻike nei kēia haʻawina pehea e haʻi ʻole ai nā biomarkers kuʻuna (i kēia hihia CRP, muscle calcin, NT-proBNP) i ka moʻolelo holoʻokoʻa. ”., #LongCovid, ke manaʻolana nei au e kamaʻilio nā kauka āpau e ʻike i kēia mau maʻi ma ka hoʻomaʻamaʻa i kēia wahi koʻikoʻi.
Ma waena o 346 mau mākua me COVID-19 (mean makahiki 43.3 mau makahiki, 52% wahine) i nānā ʻia ma hoʻokahi kikowaena ma waena o ʻApelila 2020 a me ʻOkakopa 2021, ma ka median o 109 mau lā ma hope o ka hoʻolaha ʻana, ʻo ka hōʻailona maʻamau maʻamau ka pōkole o ka hanu (62% ), palpitations (28%), atypical chest pain (27%), a me syncope (3%).
"He mea paʻakikī ka ʻike ʻana i nā mea e hana nei me nā hoʻāʻo naʻau maʻamau no ka mea paʻakikī ke ʻike i nā kūlana kūlohelohe," wahi a Puntmann.ʻO kahi hapa o ia mea e pili ana i ka pathophysiology ma hope o ia… ʻOiai inā i hoʻopaʻapaʻa ʻia kā lākou hana, ʻaʻole ia he mea koʻikoʻi no ka mea ua uku lākou me ka tachycardia a me ka puʻuwai hauʻoli loa.No laila, ʻaʻole mākou i ʻike iā lākou i ka pae decompensated. "
Hoʻolālā ka hui e hoʻomau i ka hahai ʻana i kēia mau maʻi i ka wā lōʻihi e hoʻomaopopo i ke ʻano o nā hopena lapaʻau e hiki mai ana, me ka makaʻu ʻo ia "e hōʻike i kahi kaumaha nui o ka puʻuwai naʻau mau makahiki ma ke ala," e like me ka pūnaewele o ke kikowaena.Ua hoʻomaka pū ka hui i ka MYOFLAME-19 placebo-controlled study e hoʻāʻo i nā lāʻau anti-inflammatory a me nā lāʻau lapaʻau e hana ana i ka ʻōnaehana renin-angiotensin i kēia heluna.
ʻO kā lākou aʻo ʻana i nā mea maʻi wale nō me ka ʻike ʻole ʻia o ka maʻi puʻuwai, nā comorbidities, a i ʻole nā ​​​​hōʻike hoʻāʻo ʻana o ka māmā ma ka baseline a ʻaʻole i mālama ʻia i ka haukapila no ka maʻi COVID-19.
ʻO nā mea maʻi he 95 hou ma ke keʻena ʻaʻole i loaʻa ma mua o COVID-19 a ʻaʻole i ʻike ʻia ka maʻi naʻau a i ʻole nā ​​comorbidities i hoʻohana ʻia ma ke ʻano he kaohi.ʻOiai ua ʻike ka poʻe noiʻi aia paha nā ʻokoʻa ʻike ʻole i hoʻohālikelike ʻia i nā maʻi maʻi COVID, ua ʻike lākou i ka hoʻohele like ʻana o nā mea pilikia e ka makahiki, ke kāne, a me ka maʻi cardiovascular.
Ma waena o nā mea maʻi me nā hōʻailona COVID, ʻo ka hapa nui he haʻahaʻa a haʻahaʻa paha (38% a me 33%, kēlā me kēia), a ʻeiwa wale nō (3%) i loaʻa nā hōʻailona koʻikoʻi i kaupalena ʻia nā hana o kēlā me kēia lā.
ʻO nā kumu e wānana kūʻokoʻa ana i nā hōʻailona cardiac mai ka scan baseline e nānā hou ma kahi o 4 mau mahina ma hope (median 329 mau lā ma hope o ka hōʻoia ʻana) ʻo ia ke kāne wahine a me ke komo ʻana o ka myocardial ma ka baseline.
"ʻO ka mea nui, no ka mea ua pili kā mākou noiʻi ʻana i nā poʻe me ka maʻi pre-COVID, ʻaʻole ia i hōʻike i ka laha o nā hōʻailona puʻuwai post-COVID," i kākau ai ka hui o Puntman."Akā naʻe, hāʻawi ia i ka ʻike koʻikoʻi e pili ana i kā lākou spectrum a me ka hoʻomohala ʻana."
Ua hōʻike ʻo Puntmann a me ka mea kākau kumu i nā uku kamaʻilio mai Bayer a me Siemens, a me nā haʻawina hoʻonaʻauao mai Bayer a me NeoSoft.
Kuhi kumu: Puntmann VO et al "Loaʻa ka maʻi maʻi maʻi maʻi i nā poʻe me ka maʻi maʻi COVID-19", Nature Med 2022;DOI: 10.1038/s41591-022-02000-0.
ʻO nā mea ma kēia pūnaewele no ka ʻike ʻike wale nō a ʻaʻole e pani i ka ʻōlelo aʻo lapaʻau, hōʻoia, a i ʻole ka mālama ʻana mai kahi mea mālama olakino kūpono.© 2022 MedPage Today LLC.Ua mālama ʻia nā kuleana āpau.ʻO Medpage Today kekahi o nā hōʻailona inoa federally o MedPage Today, LLC a ʻaʻole hiki ke hoʻohana ʻia e nā ʻaoʻao ʻekolu me ka ʻole o ka ʻae ʻia.