Shafi Ahmed M A, Shaikh Safwan A, Shirke Manasi M, Iddawela Sashini, Harky Amer
Department of Cardiothoracic Surgery, Barts Heart Centre, St Bartholomew's Hospital, London, UK.
Department of Medicine, Queen's University Belfast, Belfast, UK.
J Card Surg. 2020 Aug;35(8):1988-2008. doi: 10.1111/jocs.14808. Epub 2020 Jul 11.
The coronavirus disease-2019 (COVID-19) pandemic has resulted in the worst global pandemic of our generation, affecting 215 countries with nearly 5.5 million cases. The association between COVID-19 and the cardiovascular system has been well described. We sought to systematically review the current published literature on the different cardiac manifestations and the use of cardiac-specific biomarkers in terms of their prognostic value in determining clinical outcomes and correlation to disease severity.
A systematic literature review across PubMed, Cochrane database, Embase, Google Scholar, and Ovid was performed according to PRISMA guidelines to identify relevant articles that discussed risk factors for cardiovascular manifestations, cardiac manifestations in COVID-19 patients, and cardiac-specific biomarkers with their clinical implications on COVID-19.
Sixty-one relevant articles were identified which described risk factors for cardiovascular manifestations, cardiac manifestations (including heart failure, cardiogenic shock, arrhythmia, and myocarditis among others) and cardiac-specific biomarkers (including CK-MB, CK, myoglobin, troponin, and NT-proBNP). Cardiovascular risk factors can play a crucial role in identifying patients vulnerable to developing cardiovascular manifestations of COVID-19 and thus help to save lives. A wide array of cardiac manifestations is associated with the interaction between COVID-19 and the cardiovascular system. Cardiac-specific biomarkers provide a useful prognostic tool in helping identify patients with the severe disease early and allowing for escalation of treatment in a timely fashion.
COVID-19 is an evolving pandemic with predominate respiratory manifestations, however, due to the interaction with the cardiovascular system; cardiac manifestations/complications feature heavily in this disease, with cardiac biomarkers providing important prognostic information.
2019年冠状病毒病(COVID-19)大流行已成为我们这一代人经历的最严重的全球大流行,影响了215个国家,病例近550万例。COVID-19与心血管系统之间的关联已得到充分描述。我们试图系统地回顾当前已发表的文献,了解不同的心脏表现以及心脏特异性生物标志物在确定临床结局方面的预后价值及其与疾病严重程度的相关性。
根据PRISMA指南,在PubMed、Cochrane数据库、Embase、谷歌学术和Ovid上进行了系统的文献综述,以识别讨论心血管表现风险因素、COVID-19患者心脏表现以及心脏特异性生物标志物及其对COVID-19临床意义的相关文章。
共识别出61篇相关文章,这些文章描述了心血管表现的风险因素、心脏表现(包括心力衰竭、心源性休克、心律失常和心肌炎等)以及心脏特异性生物标志物(包括肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)、肌红蛋白、肌钙蛋白和N末端脑钠肽前体(NT-proBNP))。心血管风险因素在识别易发生COVID-19心血管表现的患者中可发挥关键作用,从而有助于挽救生命。一系列心脏表现与COVID-19和心血管系统之间的相互作用有关。心脏特异性生物标志物为帮助早期识别重症患者并及时升级治疗提供了有用的预后工具。
COVID-19是一种不断演变的大流行病,主要表现为呼吸系统症状,然而,由于与心血管系统相互作用,心脏表现/并发症在该疾病中占很大比重,心脏生物标志物提供重要的预后信息。