Department of Cardiology, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
Department of Heart Function, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Changzhou, China.
Heart. 2020 Aug;106(15):1142-1147. doi: 10.1136/heartjnl-2020-317062. Epub 2020 May 27.
Coronavirus disease 2019 (COVID-19) has produced a significant health burden worldwide, especially in patients with cardiovascular comorbidities. The aim of this systematic review and meta-analysis was to assess the impact of underlying cardiovascular comorbidities and acute cardiac injury on in-hospital mortality risk.
PubMed, Embase and Web of Science were searched for publications that reported the relationship of underlying cardiovascular disease (CVD), hypertension and myocardial injury with in-hospital fatal outcomes in patients with COVID-19. The ORs were extracted and pooled. Subgroup and sensitivity analyses were performed to explore the potential sources of heterogeneity.
A total of 10 studies were enrolled in this meta-analysis, including eight studies for CVD, seven for hypertension and eight for acute cardiac injury. The presence of CVD and hypertension was associated with higher odds of in-hospital mortality (unadjusted OR 4.85, 95% CI 3.07 to 7.70; I=29%; unadjusted OR 3.67, 95% CI 2.31 to 5.83; I=57%, respectively). Acute cardiac injury was also associated with a higher unadjusted odds of 21.15 (95% CI 10.19 to 43.94; I=71%).
COVID-19 patients with underlying cardiovascular comorbidities, including CVD and hypertension, may face a greater risk of fatal outcomes. Acute cardiac injury may act as a marker of mortality risk. Given the unadjusted results of our meta-analysis, future research are warranted.
2019 年冠状病毒病（COVID-19）在全球范围内造成了巨大的健康负担，尤其对合并心血管疾病的患者影响更大。本系统评价和荟萃分析的目的是评估潜在心血管合并症和急性心脏损伤对住院死亡率风险的影响。
检索 PubMed、Embase 和 Web of Science 以获取报告 COVID-19 患者潜在心血管疾病（CVD）、高血压和心肌损伤与住院死亡结局之间关系的文献。提取并汇总 OR 值。进行亚组和敏感性分析以探索潜在的异质性来源。
共有 10 项研究纳入本荟萃分析，其中 8 项研究用于 CVD，7 项研究用于高血压，8 项研究用于急性心脏损伤。存在 CVD 和高血压与更高的住院死亡率几率相关（未经调整的 OR 4.85，95%CI 3.07 至 7.70；I²=29%；未经调整的 OR 3.67，95%CI 2.31 至 5.83；I²=57%，分别）。急性心脏损伤也与未经调整的 odds 更高（21.15，95%CI 10.19 至 43.94；I²=71%）相关。
患有潜在心血管合并症（包括 CVD 和高血压）的 COVID-19 患者可能面临更大的致命结局风险。急性心脏损伤可能是死亡率风险的标志物。鉴于本荟萃分析的未经调整结果，需要进一步的研究。
