Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
Eur Rev Med Pharmacol Sci. 2020 Nov;24(21):11395-11401. doi: 10.26355/eurrev_202011_23632.
Many studies have reported arrhythmia to be associated with coronavirus disease (COVID-19), but no meta-analysis has explored whether arrhythmia is related to COVID-19 severity. Therefore, the purpose of this study was to evaluate arrhythmia in patients with severe and non-severe COVID-19 during the current COVID-19 pandemic.
We searched PubMed, Embase, Web of Science, and the Cochrane Library for case control studies that were published between January 1 and July 25, 2020, and that had data on arrhythmia in patients with COVID-19. Random effects model was used with the odds ratio as the effect size. The frequency of arrhythmia was compared between COVID-19 patients with and without the composite endpoint of severity. We also determined the pooled prevalence of arrhythmia in patients with COVID-19. Publication bias and heterogeneity were considered by using subgroup analyses, meta-regression, and the trim and fill method.
A total of 1553 patients with COVID-19 were included in the 5 articles we obtained. Of these, 349 cases (22.47%) and 1204 cases (77.53%) were severely ill and non-severely ill inpatients with COVID-19 pneumonia, respectively. There were 790 (50.87%) male patients. A total of 105 cases (30.09%) of severely ill inpatients with COVID-19 pneumonia had arrhythmia complications, and 34 cases (2.82%) of non-severely ill inpatients with COVID-19 pneumonia had arrhythmia complications. We found arrhythmia to be significantly associated with severely ill inpatients with COVID-19 pneumonia, with a pooled odds ratio of 17.97 (95% CI (11.30, 28.55), p<0.00001).
This study showed that the incidence of arrhythmia in patients with severe COVID-19 was greater than that of those with non-severe COVID-19. Patients with severe COVID-19 had a higher risk of arrhythmia complications, which further showed that COVID-19 may be a risk factor for arrhythmia and that the incidence of arrhythmia may increase with the progression of the disease. More importantly, this meta-analysis graded the reliability of evidence for further basic and clinical research into arrhythmia in patients with COVID-19.
许多研究报告称心律失常与冠状病毒病（COVID-19）有关，但尚无荟萃分析探讨心律失常是否与 COVID-19 的严重程度有关。因此，本研究旨在评估当前 COVID-19 大流行期间重症和非重症 COVID-19 患者的心律失常情况。
我们检索了 2020 年 1 月 1 日至 7 月 25 日期间发表的病例对照研究，这些研究的数据均涉及 COVID-19 患者的心律失常。采用随机效应模型，以比值比作为效应量。比较 COVID-19 患者中严重复合终点组和非严重复合终点组的心律失常发生率。我们还确定了 COVID-19 患者心律失常的总体患病率。通过亚组分析、meta 回归和修剪填充法考虑发表偏倚和异质性。
从我们获得的 5 篇文章中，共纳入了 1553 例 COVID-19 患者。其中，349 例（22.47%）和 1204 例（77.53%）分别为重症和非重症 COVID-19 肺炎住院患者。共有 790 例（50.87%）男性患者。COVID-19 肺炎重症住院患者中共有 105 例（30.09%）发生心律失常并发症，非重症住院患者中共有 34 例（2.82%）发生心律失常并发症。我们发现心律失常与 COVID-19 肺炎重症住院患者显著相关，合并比值比为 17.97（95%CI（11.30，28.55），p<0.00001）。
本研究表明，重症 COVID-19 患者的心律失常发生率高于非重症 COVID-19 患者。重症 COVID-19 患者发生心律失常并发症的风险更高，这进一步表明 COVID-19 可能是心律失常的一个危险因素，且心律失常的发生率可能随着疾病的进展而增加。更重要的是，该荟萃分析对 COVID-19 患者心律失常的进一步基础和临床研究的证据进行了分级。
