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Ngelixa ixesha elide i-COVID ibambe iimfihlakalo ezininzi, abaphandi bafumene imikhondo kwiimpawu eziqhelekileyo zentliziyo kwezi zigulana, becebisa ukuba ukudumba okuzingileyo ngumlamli.
Kwiqela labaguli be-COVID-19 ababesempilweni ngaphambili abangama-346, uninzi lwabo oluye lwahlala luneempawu emva kweenyanga ezi-4, ukuphakama kweempawu zesifo sentliziyo kunye nokwenzakala kwentliziyo okanye ukungasebenzi kwakunqabile.
Kodwa kukho imiqondiso emininzi yeengxaki zentliziyo engaphantsi, ingxelo uValentina O. Puntmann, MD, isibhedlele seYunivesithi yaseFrankfurt, eJamani, kunye noogxa bakhe kwiNature Medicine.
Xa kuthelekiswa nolawulo olungosulelwanga, abaguli be-COVID babenoxinzelelo lwegazi lwe-diastolic oluphezulu kakhulu, lonyuse kakhulu amanxeba angeyo-ischemic myocardial ngenxa yophuculo lwasemva kwexesha le-gadolinium, ukubonwa kwe-pericardial effusion engahambelaniyo ne-hemodynamically, kunye ne-pericardial effusion.<0,001). <0.001).
Ukongeza, i-73% yezigulana ze-COVID-19 ezineempawu zentliziyo zinemilinganiselo ephezulu ye-MRI yentliziyo (CMR) kunabantu abangenazimpawu, ebonisa ukudumba kwe-myocardial kunye nokwanda okukhulu kokuchasana kwe-pericardial.
“Into esiyibonayo ayilunganga,” uPuntmann uxelele iMedPage Namhlanje."Ezi zizigulane eziqhelekileyo ngaphambili."
Ngokuchaseneyo noko kudla ngokucingelwa ukuba yingxaki yentliziyo nge-COVID-19, ezi ziphumo zibonelela ngembono yokuba abaguli abaneengxaki zentliziyo esele bekho badla ngokulaliswa esibhedlele ngokugula kakhulu kunye neziphumo.
Iqela likaPuntman lifunde abantu abangenazo iingxaki zentliziyo ukuzama ukuqonda ifuthe le-COVID-19 ngokwayo, lisebenzisa imifanekiso ye-MRI yenqanaba lophando yezigulana ezifakwe kwiiklinikhi zabo ngoogqirha bosapho, amaziko ezempilo, izixhobo zokwazisa ezisasazwa ngabaguli kwi-Intanethi.Amaqela kunye neewebhusayithi..
UPuntmann uqaphele ukuba ngelixa eli liqela elikhethiweyo lezigulana ezinokungameli iimeko ezibuthathaka ze-COVID-19, ayiqhelekanga ukuba ezi zigulana zifune iimpendulo kwiimpawu zazo.
Idatha yophando lwe-Federal ibonisa ukuba iipesenti ezili-19 zabantu abadala baseMelika abosulelwe yi-COVID babeneempawu kwiinyanga ezi-3 okanye ngaphezulu emva kosulelo.Kuphononongo lwangoku, iskena esilandelelweyo umndilili weenyanga ezili-11 emva kokuxilongwa kwe-COVID-19 kubonise iimpawu eziqhubekayo zentliziyo kuma-57% abathathi-nxaxheba.Abo bahlala beempawu babene-edema ye-myocardial esasazeke ngakumbi kunabo babuya okanye abazange babe neempawu (i-T2 yendalo 37.9 vs 37.4 kunye ne-37.5 ms, P = 0.04).
"Ukubandakanyeka kwentliziyo yinxalenye ebalulekileyo yokubonakaliswa kwexesha elide kwe-COVID-kungoko i-dyspnea, ukunganyamezeli umzamo, i-tachycardia," utshilo uPontman kudliwanondlebe.
Iqela lakhe lagqiba kwelokuba iimpawu zentliziyo abazibonileyo “zinxulunyaniswa nesilonda esincinci sentliziyo, esinokuchaza, ubuncinci, isiseko se-pathophysiological seempawu zentliziyo ezizingisileyo.Ngokucacileyo, ukwenzakala okukhulu kwe-myocardial okanye isifo sentliziyo asiyomeko esele ikhona kwaye iimpawu azihambelani nenkcazo yeklasi ye-viral myocarditis. "
Ugqirha weCardiologist kunye nesigulana se-COVID sexesha elide u-Alice A. Perlowski, MD, wachaza iziphumo ezibalulekileyo zekliniki ngokuthumela i-tweeting: "Olu phononongo lubonisa indlela i-biomarkers yendabuko (kule meko i-CRP, i-muscle calcin, i-NT-proBNP) inokungaxeleli ibali lonke. ”., #LongCovid, ndiyathemba ukuba bonke oogqirha ababona ezi zigulana zisebenza bayayilungisa le ngongoma ibalulekileyo. "
Phakathi kwabantu abadala abangama-346 abane-COVID-19 (iminyaka eyi-43.3 yobudala, i-52% yabasetyhini) bavavanywa kwiziko elinye phakathi kuka-Epreli 2020 kunye no-Okthobha ka-2021, kumdibaniso weentsuku ezili-109 emva kokuvezwa, olona phawu luqhelekileyo lwentliziyo yayikukuphefumla nzima (62%) ), ukubetha (28%), intlungu yesifuba esingaqhelekanga (27%), kunye ne-syncope (3%).
“Ukwazi ukuba kuqhubeka ntoni ngovavanyo lwentliziyo oluqhelekileyo ngumceli mngeni kuba kunzima ukubona iimeko ezingaqhelekanga kakhulu,” utshilo uPuntmann.“Inxalenye yayo inento yokwenza ne-pathophysiology esemva kwayo… Nokuba umsebenzi wabo usengozini, ayixhaphakanga kangako kuba ibuyisela i-tachycardia kunye nentliziyo evuya kakhulu.Ke ngoko, asizange sibabone kwinqanaba lokuthotywa. ”
Iqela liceba ukuqhubeka nokulandela ezi zigulana kwixesha elide ukuze liqonde ukuba zinokuba yintoni iziphumo zeklinikhi, zinoloyiko lokuba "inokuthi ivakalise umthwalo omkhulu wokuphuka kwentliziyo kwiminyaka ephantsi kwendlela," ngokutsho kwewebhusayithi yeziko.Iqela liphinde laqalisa isifundo esilawulwa yi-placebo se-MYOFLAME-19 ukuvavanya iziyobisi ezichasayo kunye neziyobisi ezisebenza kwinkqubo ye-renin-angiotensin kule ndawo.
Uphononongo lwabo lubandakanya kuphela abaguli abangenaso isifo sentliziyo esaziwayo ngaphambili, i-comorbidities, okanye iimvavanyo ezingaqhelekanga zemiphunga kwinqanaba lokuqala kwaye abangazange balaliswe esibhedlele ngenxa ye-COVID-19 eqatha.
Izigulana ezingama-95 ezongezelelweyo ekliniki ezazingenayo i-COVID-19 ngaphambili kwaye zingenasifo sentliziyo saziwayo okanye izifo eziye zasetyenziswa njengolawulo.Ngelixa abaphandi bevuma ukuba kunokubakho umahluko ongaqondwayo xa kuthelekiswa nezigulana ze-COVID, baphawule ukusasazwa okufanayo kwemingcipheko yobudala, isini, kunye nesifo sentliziyo.
Phakathi kwezigulana ezineempawu ze-COVID, uninzi lwalunobulali okanye luphakathi (38% kunye ne-33%, ngokulandelanayo), kwaye kuphela abalithoba (3%) babeneempawu ezinzima ezinciphisa imisebenzi yemihla ngemihla.
Izinto eziqikelela ngokuzimeleyo iimpawu zentliziyo ukusuka kwisiseko sokuskena ukuphinda kuphinde kuhlolwe ubuncinci kwiinyanga ezi-4 kamva (iintsuku eziphakathi ezingama-329 emva kokuxilongwa) yayisisini sabasetyhini kwaye isasaza ukubandakanyeka kwe-myocardial kwisiseko.
Ngokukodwa, ngenxa yokuba uphononongo lwethu lugxile kubantu abanesifo sangaphambi kwe-COVID, alukhange luxele ukuxhaphaka kweempawu zentliziyo emva kwe-COVID,” iqela likaPuntman labhala."Nangona kunjalo, ibonelela ngolwazi olubalulekileyo malunga nembonakalo yabo kunye nendaleko elandelayo."
UPuntmann kunye nombhali-mbhali badize imirhumo yokuthetha evela kwi-Bayer kunye ne-Siemens, kunye nezibonelelo zemfundo ezivela kwi-Bayer kunye ne-NeoSoft.
Umthombo wocaphulo: I-Puntmann VO et al “Isifo sentliziyo sexesha elide kubantu abanesifo se-COVID-19 esingephi”, i-Nature Med 2022;I-DOI: 10.1038/s41591-022-02000-0.
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