Department of Epidemiology, School of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou 450001, China.
Department of Toxicology, Henan Center for Disease Control and Prevention, Zhengzhou 450016, China.
J Stroke Cerebrovasc Dis. 2020 Nov;29(11):105283. doi: 10.1016/j.jstrokecerebrovasdis.2020.105283. Epub 2020 Aug 28.
The aim of this study was to address the association between cerebrovascular disease and adverse outcomes in coronavirus disease 2019 (COVID-19) patients by using a quantitative meta-analysis based on adjusted effect estimates.
A systematic search was performed in PubMed, Web of Science, and EMBASE up to August 10th, 2020. The adjusted effect estimates were extracted and pooled to evaluate the risk of the unfavorable outcomes in COVID-19 patients with cerebrovascular disease. Subgroup analysis and meta-regression were also carried out.
There were 12 studies with 10,304 patients included in our meta-analysis. A significant trend was observed when evaluating the association between cerebrovascular disease and adverse outcomes (pooled effect = 2.05, 95% confidence interval (CI): 1.34-3.16). In addition, the pooled effects showed that patients with a history of cerebrovascular disease had more likelihood to progress fatal outcomes than patients without a history of cerebrovascular disease (pooled effect = 1.78, 95% CI: 1.04-3.07).
This study for the first time indicated that cerebrovascular disease was an independent risk factor for predicting the adverse outcomes, particularly fatal outcomes, in COVID-19 patients on the basis of adjusted effect estimates. Well-designed studies with larger sample size are needed for further verification.
本研究旨在通过基于调整后效应估计的定量荟萃分析，探讨脑血管疾病与 2019 年冠状病毒病（COVID-19）患者不良结局之间的关联。
系统检索了 PubMed、Web of Science 和 EMBASE，检索时间截至 2020 年 8 月 10 日。提取并汇总了调整后效应估计值，以评估 COVID-19 合并脑血管疾病患者不良结局的风险。还进行了亚组分析和荟萃回归分析。
荟萃分析纳入了 12 项研究，共 10304 例患者。评估脑血管疾病与不良结局之间的关联时，观察到了显著的趋势（汇总效应=2.05，95%置信区间[CI]：1.34-3.16）。此外，汇总效应表明，有脑血管疾病史的患者比无脑血管疾病史的患者更有可能进展为致命结局（汇总效应=1.78，95%CI：1.04-3.07）。
基于调整后效应估计，本研究首次表明脑血管疾病是预测 COVID-19 患者不良结局，特别是致命结局的独立危险因素。需要进行设计更好、样本量更大的研究进一步验证。
