摘要
新型冠状病毒感染(COVID-19)已被证实可累及全身多个系统,其中心血管系统受累很常见。为帮助临床医师合理诊治COVID-19相关心血管问题,共识组建议:(1)对于因COVID-19住院或伴有心脏相关症状的患者,应常规检测心肌肌钙蛋白,以评估心肌损伤,判断有无心脏并发症;非心脏原因所致心肌损伤的患者预后较差;(2)COVID-19相关急性心肌炎较为罕见,对怀疑心肌炎的患者应根据危险分层进行诊治;(3)COVID-19可增加心血管事件风险,所有感染者应更加严格遵循健康生活方式,接受规范的心血管疾病一级或二级预防;(4)COVID-19后3个月时有持续心脏相关症状或新发相关症状,且至少持续2个月,但心血管相关检查未见异常,可考虑为“COVID-19后状态”,此类患者应以康复治疗为主。
Evidence shows that coronavirus disease 2019(COVID-19) can impact multiple bodily systems,with the cardiovascular system being commonly affected. In order to guide healthcare providers in diagnosing and managing cardiovascular issues related to COVID-19,the consensus group recommends:(1)Routine cardiac troponin testing is necessary for patients who are hospitalized or exhibit symptoms related to heart conditions after COVID-19 infection to evaluate potential myocardial injury and help detect any cardiac complications. Patients with myocardial injury not related to heart issues tend to have a poorer outcome.(2)Relatively few cases of acute myocarditis linked to COVID-19 have been reported,and individuals suspected of having myocarditis should be evaluated and managed based on risk stratification.(3)COVID-19 infection should be considered a risk factor for increasing the incidence of cardiovascular disease. All individuals who have been infected should adhere to a healthy lifestyle more strictly and implement appropriate primary or secondary preventive measures for cardiovascular disease.(4)For individuals who experience the persistence or emergence of new symptoms 3 months after the initial COVID-19 infection and have been experiencing these symptoms for at least 2 months,with no clear diagnosis of a cardiovascular disease through standard diagnostic tests,it is advisable to consider the possibility of "post COVID-19 condition". Rehabilitation should be given top priority for these patients.
作者
国家老年医学中心
中国老年医学学会心电与心功能分会
北京医学会心血管病学分会影像学组
中国医药卫生文化协会心血管健康与科学运动分会
汪芳
杨杰孚
杨进刚
郭颖
孟旭阳
夏辰兮
徐涛
王翔
National Center of Gerontology;Electrocardiology and Cardiac Function Branch of Chinese Geriatric Society;Imaging Group of Cardiovascular Department;Beijing Medical Association,Chinese Medical and Health Culture Association Cardiovascular Health and Science Sports Branch of China Health Culture Association;WANG Fang;YANG Jiefu
出处
《中国全科医学》
CAS
北大核心
2023年第14期1692-1702,共11页
Chinese General Practice
基金
国家重点研发计划项目(2020YFC2008100)。
