Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan province, China.
College of Nursing, Gannan Medical University, Ganzhou, Jiangxi province, China.
Nutr Metab Cardiovasc Dis. 2021 Jan 4;31(1):2-13. doi: 10.1016/j.numecd.2020.09.004. Epub 2020 Sep 11.
Emerging data have linked the presence of cardiac injury with a worse prognosis in novel coronavirus disease 2019 (COVID-19) patients. However, available data cannot clearly characterize the correlation between cardiac injury and COVID-19. Thus, we conducted a meta-analysis of recent studies to 1) explore the prevalence of cardiac injury in different types of COVID-19 patients and 2) evaluate the association between cardiac injury and worse prognosis (severe disease, admission to ICU, and mortality) in patients with COVID-19.
Literature search was conducted through PubMed, the Cochrane Library, Embase, and MedRxiv databases. A meta-analysis was performed with Stata 14.0. A fixed-effects model was used if the I values ≤ 50%, otherwise the random-effects model was performed. The prevalence of cardiac injury was 19% (95% CI: 0.15-0.22, and p < 0.001) in total COVID-19 patients, 36% (95% CI: 0.25-0.47, and p < 0.001) in severe COVID-19 patients, and 48% (95% CI: 0.30-0.66, and p < 0.001) in non-survivors. Furthermore, cardiac injury was found to be associated with a significant increase in the risk of poor outcomes with a pooled effect size (ES) of 8.46 (95% CI: 3.76-19.06, and p = 0.062), severe disease with an ES of 3.54 (95% CI: 2.25-5.58, and p < 0.001), admission to ICU with an ES of 5.03 (95% CI: 2.69-9.39, and p < 0.001), and mortality with an ES of 4.99 (95% CI: 3.38-7.37, and p < 0.001).
The prevalence of cardiac injury was greatly increased in COVID-19 patients, particularly in patients with severe disease and non-survivors. COVID-19 patients with cardiac injury are more likely to be associated with poor outcomes, severity of disease, admission to ICU, and mortality.
新出现的数据表明，心脏损伤与新型冠状病毒病 2019（COVID-19）患者的预后较差有关。然而，现有数据尚不能明确描述心脏损伤与 COVID-19 之间的相关性。因此，我们对最近的研究进行了荟萃分析，以 1）探讨不同类型 COVID-19 患者中心脏损伤的发生率，2）评估 COVID-19 患者中心脏损伤与预后不良（重症、入住 ICU 和死亡率）之间的关系。
通过 PubMed、Cochrane 图书馆、Embase 和 MedRxiv 数据库进行文献检索。使用 Stata 14.0 进行荟萃分析。如果 I ²值≤50%，则使用固定效应模型，否则使用随机效应模型。在总 COVID-19 患者中，心脏损伤的发生率为 19%（95%CI：0.15-0.22，p<0.001），在重症 COVID-19 患者中为 36%（95%CI：0.25-0.47，p<0.001），在非幸存者中为 48%（95%CI：0.30-0.66，p<0.001）。此外，心脏损伤与不良结局风险显著增加相关，汇总效应大小（ES）为 8.46（95%CI：3.76-19.06，p=0.062），重症疾病 ES 为 3.54（95%CI：2.25-5.58，p<0.001），入住 ICU 的 ES 为 5.03（95%CI：2.69-9.39，p<0.001），死亡率的 ES 为 4.99（95%CI：3.38-7.37，p<0.001）。
COVID-19 患者中心脏损伤的发生率显著增加，尤其是在重症患者和非幸存者中。患有心脏损伤的 COVID-19 患者更有可能与不良结局、疾病严重程度、入住 ICU 和死亡率相关。
