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青紫型先天性心脏病中的新型冠状病毒肺炎

COVID-19 in Cyanotic Congenital Heart Disease.

作者信息

Ammar Lama A, Nassar Joseph E, Bitar Fadi, Arabi Mariam

机构信息

Faculty of Medicine and Medical Center, American University of Beirut, Bliss Street, 11-0236, Riad El-Solh, Beirut 1107-2020, Lebanon.

出版信息

Can J Infect Dis Med Microbiol. 2023 Apr 18;2023:5561159. doi: 10.1155/2023/5561159. eCollection 2023.

Abstract

Congenital heart disease (CHD) is the most prevalent congenital defect in newborn infants. Due to the various types of heart abnormalities, CHD can have a wide range of symptoms. Cardiac lesions comprise a range of different types and accordingly varying severities. It is highly helpful to classify CHD into cyanotic and acyanotic heart diseases. In this review, we are investigating the course of Coronavirus disease 2019 (COVID-19) in cyanotic CHD patients. The infection may directly or indirectly affect the heart by affecting the respiratory system and other organs. The effect on the heart that is pressure- or volume-overloaded in the context of CHD is theoretically more severe. Patients with CHD are at a higher risk of mortality from COVID-19 infection or suffering worse complications. While the anatomic complexity of CHD does not seem to predict the severity of infection, patients with worse physiological stages are more susceptible such as cyanosis and pulmonary hypertension. Patients with CHD exhibit continuous hypoxemia and have lower oxygen saturations because of a right-to-left shunt. Such individuals run the danger of rapidly deteriorating in the event of respiratory tract infections with inadequate oxygenation. Additionally, these patients have a higher risk of paradoxical embolism. Hence, critical care should be given to cyanotic heart disease patients with COVID-19 in comparison to acyanotic patients and this is through proper management, close observation, and adequate medical therapy.

摘要

先天性心脏病(CHD)是新生儿中最常见的先天性缺陷。由于心脏异常的类型多样,CHD可出现广泛的症状。心脏病变包括一系列不同类型,严重程度也各不相同。将CHD分为青紫型和非青紫型心脏病非常有帮助。在本综述中,我们正在研究2019冠状病毒病(COVID-19)在青紫型CHD患者中的病程。该感染可能通过影响呼吸系统和其他器官直接或间接影响心脏。理论上,在CHD背景下对压力或容量负荷过重的心脏的影响更为严重。CHD患者因COVID-19感染而死亡或出现更严重并发症的风险更高。虽然CHD的解剖复杂性似乎不能预测感染的严重程度,但生理状态较差的患者更容易感染,如出现青紫和肺动脉高压。由于存在右向左分流,CHD患者表现为持续性低氧血症且血氧饱和度较低。这类个体在呼吸道感染且氧合不足时存在迅速恶化的风险。此外,这些患者发生反常栓塞的风险更高。因此,与非青紫型患者相比,对于患有COVID-19的青紫型心脏病患者应给予重症监护,这需要通过适当的管理、密切观察和充分的药物治疗来实现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad56/10129433/d413d3a70196/CJIDMM2023-5561159.001.jpg

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