Meng Meng, Zhao Qianwen, Kumar Rahul, Bai Chen, Deng Yunlei, Wan Bo
Digestion Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
Department of Gastroenterology and Hepatology, Sichuan University-Oxford University Huaxi Gastrointestinal Cancer Centre, West China Hospital, Sichuan University, Chengdu, China.
Aging (Albany NY). 2020 Nov 16;12(22):23409-23421. doi: 10.18632/aging.103991.
We examined the effects of coronary heart disease (CHD), hypertension and diabetes on the development of severe COVID-19. We performed a comprehensive, systematic literature search for studies published between December 2019 and July 5, 2020 in five databases. The prevalence of severe COVID-19 in patients with CHD, hypertension and diabetes was evaluated through a meta-analysis. Thirty-five articles with 8,170 patients were included, and all the available studies were case series. The pooled odds ratio for the development of severe COVID-19 was 3.21 for patients with CHD (fixed-effects model, 95% CI: 2.58-3.99), 2.27 for patients with hypertension (random-effects model, 95% CI: 1.79-2.90) and 2.34 for patients with diabetes (random-effects model, 95% CI: 1.79-3.05). The heterogeneity of the studies was moderate for the effect of CHD on COVID-19 severity, but was high for the effects of diabetes and hypertension. Funnel plots and Egger's tests revealed no publication bias in the CHD and hypertension analyses, but suggested publication bias in the diabetes analysis. This bias was corrected using the trim-and-fill method, and was ultimately found to have no effect on the results. Our findings suggest patients with CHD, hypertension and diabetes are at greater risk for developing severe COVID-19 than those without these conditions.
我们研究了冠心病（CHD）、高血压和糖尿病对重症新型冠状病毒肺炎（COVID-19）病情发展的影响。我们在五个数据库中对2019年12月至2020年7月5日期间发表的研究进行了全面、系统的文献检索。通过荟萃分析评估了冠心病、高血压和糖尿病患者中重症COVID-19的患病率。纳入了35篇涉及8170例患者的文章，所有现有研究均为病例系列研究。冠心病患者发生重症COVID-19的合并比值比为3.21（固定效应模型，95%CI：2.58 - 3.99），高血压患者为2.27（随机效应模型，95%CI：1.79 - 2.90），糖尿病患者为2.34（随机效应模型，95%CI：1.79 - 3.05）。冠心病对COVID-19严重程度影响的研究异质性为中度，但糖尿病和高血压影响的异质性较高。漏斗图和Egger检验显示冠心病和高血压分析中无发表偏倚，但糖尿病分析提示存在发表偏倚。使用修剪填充法对该偏倚进行了校正，最终发现其对结果无影响。我们的研究结果表明，与无这些疾病的患者相比，冠心病、高血压和糖尿病患者发生重症COVID-19的风险更高。
