新冠疫情爆发对重症胸痛发病影响的单中心研究
Impact of the COVID-19 outbreak on the incidence of severe chest pain:a single-center study
罗园园 1李坚 2龚杰 2王强2
作者信息
- 1. 214023 无锡,南京医科大学附属无锡人民医院临床研究中心
- 2. 214023 无锡,南京医科大学附属无锡人民医院心脏中心
- 折叠
摘要
目的 通过分析2020年新型冠状病毒肺炎(COVID-19)疫情爆发期间于南京医科大学附属无锡人民医院急诊中心就诊的严重急性胸痛(ACP)患者数量及死亡率的变化,探讨COVID-19疫情爆发对ACP发病的影响.方法 选取从2020年1月1日至2020年4月29日于无锡市人民医院急诊中心就诊并确诊为急性心肌梗死(AMI),主动脉夹层(AD)和肺动脉栓塞(PE)等三类ACP疾病患者,按照COVID-19疫情爆发造成的停复工情况将ACP患者分别纳入:①疫情爆发组(LP),为停工状态,时间2020年1月23日(武汉宣布封城,全国各城跟随)至2020年3月22日(本市疫情完全控制,次日全面复工),共60 d;②疫情爆发前后组(ULP),为正常生活工作状态,含疫情爆发前,2020年1月1日至2020年1月22日,及复工后2020年3月23日至2020年4月29日,共60 d.记录入组患者的年龄、性别等特征,比较各组患者的数量及入院期间的死亡率.结果 LP组ACP患者数量(n=63)较ULP组(n=107)下降(下降41.1%),其中AMI患者下降了46.2%(LP:42 vs.ULP:78),死亡率增高(LP:16.7%vs.ULP:6.4%,P=0.074),主要表现为STEMI患者数量下降(LP:33 vs.ULP:70,下降52.9%),死亡率增高(LP:21.2%vs.ULP:7.1%,P=0.038).LP组AD患者数量(n=7)较ULP组(n=20)下降65.0%,PE患者的数量上升55.6%(LP:14 vs.ULP:9).PE患者在ACP患者中构成比两组差异具有统计学意义(LP:22.2%vs.ULP:8.4%,P=0.011),AMI及AD患者在ACP患者中的构成比两组不具有统计学差异(P=0.389,P=0.192).结论 COVID-19疫情爆发期间AMI、AD患者数量下降,PE患者数量的上升,且STEMI患者死亡率显著增高,可能是疫情爆发引发的生活方式改变有关.
Abstract
Objective To explore the impact of the COVID-19 outbreak on the incidence of Acute Chest Pain(ACP)by analyzing changes in the number of patients and mortality rates of severe ACP at the Department of Clinical Research Center,the Affiliated Wuxi People's Hospital of Nanjing Medical University during the early outbreak of COVID-19 in 2020.Methods Patients diagnosed with three types of ACP diseases:Acute Myocardial Infarction(AMI),Aortic Dissection(AD),and Pulmonary Embolism(PE)who visited the Emergency Center of Wuxi People's Hospital from January 1,2020,to April 29,2020,were selected.Based on the COVID-19 outbreak and the corresponding work suspension and resumption,ACP patients were divided into:①Lockdown Period(LP)group,covering the suspension period from January 23,2020(when Wuhan announced lockdown and other cities followed)to March 22,2020(when the epidemic was completely controlled in the city and work resumed the next day),a total of 60 days;②Unlocked Period(ULP)group,reflecting the normal living and working state,including the period before the outbreak from January 1,2020,to January 22,2020,and after work resumption from March 23,2020,to April 29,2020,also a total of 60 days.Age,gender,and other characteristics of the enrolled patients were recorded,and the number of patients and mortality rates during hospitalization in each group were compared.Results The number of ACP patients in the LP group(n=63)decreased by 41.1%compared to the ULP group(n=107),with a 46.2%decrease in AMI patients(LP:42 vs.ULP:78)and an increase in mortality rate(LP:16.7%vs.ULP:6.4%,P=0.074).This was mainly reflected in the decrease in STEMI patients(LP:33 vs.ULP:70,a decrease of 52.9%)and an increase in mortality rate(LP:21.2%vs.ULP:7.1%,P=0.038).The number of AD patients in the LP group(n=7)decreased by 65.0%compared to the ULP group(n=20),while the number of PE patients increased by 55.6%(LP:14 vs.ULP:9).The proportion of PE patients among all ACP cases was statistically different between the two groups(LP:22.2%vs.ULP:8.4%,P=0.011).There was no statistical difference in the proportion of AMI and AD patients among ACP cases between the two groups(P=0.389,P=0.192).Conclusion During the COVID-19 outbreak,there was a decrease in the number of AMI and AD patients,an increase in PE patients,and a significant rise in the mortality rate of STEMI patients.These changes may be related to lifestyle changes triggered by the outbreak.
关键词
急性心肌梗死/COVID-19/急性胸痛疾病/主动脉夹层/肺动脉栓塞Key words
COVID-19/Acute chest pain disease/Acute myocardial infarction/Aortic dissection/Pulmonary embolism引用本文复制引用
基金项目
江苏省无锡市科教强卫医学重点人才项目(ZDRC037)
出版年
2024
NETL
NSTL
万方数据