{"title":"Hemodynamic Alterations in Cardiac Function Among Patients With Stroke and SARS-CoV-2 Infection: A Retrospective Cohort Study","authors":"Mingchao Zhou, Fubing Zha, Liuyang Zhao, Dongxia Li, Jiao Luo, Yao Wang, Fang Liu, Jing Zhou, Zeyu Zhang, Yucong Zou, Feng Xiong, Dianrui Hou, Fei Li, Mingjun He, Yongjie Zhu, Yulong Wang","doi":"10.1155/2024/2047103","DOIUrl":null,"url":null,"abstract":"<div>\n <p><b>Objective:</b> Cardiovascular complications associated with COVID-19 are being increasingly recognized. They include potential long-term effects on the heart, although how these complications manifest in patients with stroke who are already vulnerable to cardiovascular issues is lacking. This study addressed this gap by investigating the influence of SARS-CoV-2 infection on cardiac hemodynamic changes in inpatients with stroke, thereby providing valuable insights into the management of cardiac complications in this population.</p>\n <p><b>Methods:</b> This retrospective cohort study enrolled inpatients with stroke who did or did not experience SARS-CoV-2 infection in Shenzhen Second People’s Hospital. Clinical information, hemodynamics data, serum myocardial enzyme levels, functional levels, including Barthel index, and Longshi scale assessment (bedridden, domestic, and community) were extracted from clinical records. An independent sample <i>t</i>-test and the Mann–Whitney <i>U</i> test were used for comparison between groups. Multiple logistic regression analysis was used to identify indicators associated with decline in cardiac function in patients with stroke post-COVID-19.</p>\n <p><b>Results:</b> Eighty-three patients with stroke (average age of 66.0 ± 15.5 years) were recruited (42 patients in the study group and 41 in the control group). No significant difference in general characteristics was observed between the groups. The ejection fraction (EF, 56.45 ± 12.46 vs. 47.64 ± 14.76, <i>p</i> = 0.04) was decreased, and the end-diastolic volume (EDV, 142.74 ± 80.00 vs. 193.34 ± 140.17, <i>p</i> = 0.001) was increased significantly in patients infected with SARS-CoV-2 compared with the noninfected participants. SARS-CoV-2 infection was an independent risk factor for EF (−10%) decrease (OR: 5.205, 95% CI: 1.621–16.720, <i>p</i> = 0.006). The risk of cardiac function decline among bedridden infected patients was 15.43 times higher than that of uninfected nonbedridden patients (OR: 15.430, 95% CI: 1.402–169.805, <i>p</i> = 0.025).</p>\n <p><b>Conclusion:</b> Patients who are bedridden after stroke face a higher potential risk of cardiac hemodynamic impairment following SARS-CoV-2 infection, emphasizing the need for meticulous hemodynamic monitoring during treatment and rehabilitation of these patients to prevent any potential cardiovascular complications.</p>\n <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: ChiCTR2300071376.</p>\n </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/2047103","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Practice","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/2024/2047103","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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Abstract
Objective: Cardiovascular complications associated with COVID-19 are being increasingly recognized. They include potential long-term effects on the heart, although how these complications manifest in patients with stroke who are already vulnerable to cardiovascular issues is lacking. This study addressed this gap by investigating the influence of SARS-CoV-2 infection on cardiac hemodynamic changes in inpatients with stroke, thereby providing valuable insights into the management of cardiac complications in this population.
Methods: This retrospective cohort study enrolled inpatients with stroke who did or did not experience SARS-CoV-2 infection in Shenzhen Second People’s Hospital. Clinical information, hemodynamics data, serum myocardial enzyme levels, functional levels, including Barthel index, and Longshi scale assessment (bedridden, domestic, and community) were extracted from clinical records. An independent sample t-test and the Mann–Whitney U test were used for comparison between groups. Multiple logistic regression analysis was used to identify indicators associated with decline in cardiac function in patients with stroke post-COVID-19.
Results: Eighty-three patients with stroke (average age of 66.0 ± 15.5 years) were recruited (42 patients in the study group and 41 in the control group). No significant difference in general characteristics was observed between the groups. The ejection fraction (EF, 56.45 ± 12.46 vs. 47.64 ± 14.76, p = 0.04) was decreased, and the end-diastolic volume (EDV, 142.74 ± 80.00 vs. 193.34 ± 140.17, p = 0.001) was increased significantly in patients infected with SARS-CoV-2 compared with the noninfected participants. SARS-CoV-2 infection was an independent risk factor for EF (−10%) decrease (OR: 5.205, 95% CI: 1.621–16.720, p = 0.006). The risk of cardiac function decline among bedridden infected patients was 15.43 times higher than that of uninfected nonbedridden patients (OR: 15.430, 95% CI: 1.402–169.805, p = 0.025).
Conclusion: Patients who are bedridden after stroke face a higher potential risk of cardiac hemodynamic impairment following SARS-CoV-2 infection, emphasizing the need for meticulous hemodynamic monitoring during treatment and rehabilitation of these patients to prevent any potential cardiovascular complications.
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