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冠状病毒病(COVID-19):一项系统综述和荟萃分析,以评估各种合并症对严重事件的影响。

Coronavirus disease (COVID-19): A systematic review and meta-analysis to evaluate the impact of various comorbidities on serious events.

作者信息

Nandy Kunal, Salunke Abhijeet, Pathak Subodh Kumar, Pandey Apurva, Doctor Chinmay, Puj Ketul, Sharma Mohit, Jain Abhishek, Warikoo Vikas

机构信息

Department of Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India.

Department of Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India.

出版信息

Diabetes Metab Syndr. 2020 Sep-Oct;14(5):1017-1025. doi: 10.1016/j.dsx.2020.06.064. Epub 2020 Jul 2.

Abstract

BACKGROUND AND AIMS

Currently there is limited knowledge on medical comorbidities and COVID-19; we conducted a systematic review and meta-analysis to evaluate the impact of various morbidities on serious events in COVID 19.

METHODS

PubMed, Cochrane Central Register of Clinical Trials were searched on April 28, 2020, to extract published articles that reported the outcomes of COVID-19 patients. The search terms were "coronavirus" and "clinical characteristics". ICU admission, mechanical ventilation, ARDS, Pneumonia, death was considered serious events. The comorbidities assessed in the study were Hypertension (HTN), Diabetes mellitus (DM), Cardiovascular diseases (CVD), Chronic obstructive pulmonary disease (COPD) and Chronic Kidney disease (CKD). Subsequently, comparisons between comorbidity patient group and the non-comorbidity patient groups, in terms of serious events were made using the pooled estimates of odd's ratio (OR) RESULTS: We identified 688 published results and 16 studies with 3994 patients were included in the systematic review. Serious events were seen in 526(13.16%) patients. Presence of hypertension with OR 2.95, diabetes mellitus with OR 3.07, Cardio vascular disease with OR 4.58, COPD with OR 6.66 and Chronic kidney disease with OR 5.32 had significant association in patients with COVID 19 on having serious events. Presence of diabetes mellitus (OR 2.78)) had a significant impact on death in COVID 19 patients with a p-value 0.004.

CONCLUSIONS

Presence of medical comorbidities in COVID-19 leads to higher risk of developing serious events i.e. ICU admission, mechanical intubation and mortality. The presence of Diabetes mellitus has a significant impact on mortality rate in COVID-19 patients.

摘要

背景与目的

目前关于合并症与新型冠状病毒肺炎(COVID-19)的了解有限;我们进行了一项系统评价和荟萃分析,以评估各种合并症对COVID-19严重事件的影响。

方法

于2020年4月28日检索了PubMed、Cochrane临床试验中心注册库,以提取报告COVID-19患者结局的已发表文章。检索词为“冠状病毒”和“临床特征”。入住重症监护病房(ICU)、机械通气、急性呼吸窘迫综合征(ARDS)、肺炎、死亡被视为严重事件。本研究评估的合并症包括高血压(HTN)、糖尿病(DM)、心血管疾病(CVD)、慢性阻塞性肺疾病(COPD)和慢性肾脏病(CKD)。随后,使用比值比(OR)的合并估计值对合并症患者组和非合并症患者组在严重事件方面进行比较。结果:我们确定了688篇已发表的结果,16项研究共3994例患者被纳入系统评价。526例(13.16%)患者出现严重事件。高血压患者发生严重事件的OR为2.95,糖尿病患者为3.07,心血管疾病患者为4.58,COPD患者为6.66,慢性肾脏病患者为5.32,这些合并症与COVID-19患者发生严重事件有显著关联。糖尿病(OR 2.78)对COVID-19患者的死亡有显著影响,P值为0.004。

结论

COVID-19患者存在合并症会导致发生严重事件(即入住ICU、机械通气和死亡)的风险更高。糖尿病的存在对COVID-19患者的死亡率有显著影响。

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