新型冠状病毒肺炎患者的急性心脏损伤
Acute cardiac injury in patients with COVID-19.
作者信息
De Lorenzo Andrea, Kasal Daniel Ab, Tura Bernardo R, Lamas Cristiane C, Rey Helena Cv
机构信息
Instituto Nacional de Cardiologia, Research and Teaching Department Rio de Janeiro, RJ, Brazil.
出版信息
Am J Cardiovasc Dis. 2020 Jun 15;10(2):28-33. eCollection 2020.
Abstract
INTRODUCTION
Cardiac complications of COVID-19 are potentially life-threatening. The occurrence of myocardial injury in the context of COVID-19 is multifactorial and has generated increasing interest.
METHODS
A systematic review with a meta-analysis of the literature was performed. MEDLINE and EMBASE were searched. Two independent reviewers evaluated the selected manuscripts for the outcome "myocardial injury", defined by troponin elevation above the 99th percentile. The study heterogeneity and risk of bias were evaluated.
RESULTS
Eight studies, with a total of 1,229 patients, were included. The frequency of myocardial injury was 16% (95% CI: 9%-27%). The heterogeneity among the studies was high (93%).
CONCLUSIONS
Myocardial injury may occur in patients with COVID-19, with a frequency of 16% according to current studies. Continuous research is needed to update these findings as the pandemic evolves and to define the implications of myocardial injury in the context of this infection.
摘要
引言
新型冠状病毒肺炎（COVID-19）的心脏并发症可能危及生命。COVID-19背景下心肌损伤的发生是多因素的，并且已引起越来越多的关注。
方法
进行了一项文献的系统评价和荟萃分析。检索了MEDLINE和EMBASE。两名独立的评审员评估了所选手稿中“心肌损伤”的结果，该结果由肌钙蛋白升高至第99百分位数以上定义。评估了研究的异质性和偏倚风险。
结果
纳入了八项研究，共1229例患者。心肌损伤的发生率为16%（95%置信区间：9%-27%）。研究之间的异质性较高（93%）。
结论
COVID-19患者可能发生心肌损伤，根据目前的研究，发生率为16%。随着疫情的演变，需要持续开展研究以更新这些发现，并确定心肌损伤在这种感染背景下的意义。
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本文引用的文献
1
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Eur J Heart Fail. 2020 May;22(5):911-915. doi: 10.1002/ejhf.1828. Epub 2020 Apr 11.
2
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Circulation. 2020 Jun 2;141(22):1733-1735. doi: 10.1161/CIRCULATIONAHA.120.047008. Epub 2020 Apr 6.
3
Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19).COVID-19 患者的致命结局对心血管的影响。
JAMA Cardiol. 2020 Jul 1;5(7):811-818. doi: 10.1001/jamacardio.2020.1017.
4
Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China.新冠肺炎住院患者中心脏损伤与死亡的相关性研究：中国武汉。
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5
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Eur Heart J. 2021 Jan 7;42(2):206. doi: 10.1093/eurheartj/ehaa190.
6
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Intensive Care Med. 2020 May;46(5):846-848. doi: 10.1007/s00134-020-05991-x. Epub 2020 Mar 3.
9
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Lancet Respir Med. 2020 May;8(5):475-481. doi: 10.1016/S2213-2600(20)30079-5. Epub 2020 Feb 24.
10
Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China.《武汉 2019 年新型冠状病毒感染的肺炎 138 例住院患者临床特征分析》
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