Bae SungA, Kim So Ree, Kim Mi-Na, Shim Wan Joo, Park Seong-Mi
Division of Cardiology, Korea University Anam Hospital, Seoul, Korea (the Republic of).
Division of Cardiology, Korea University Anam Hospital, Seoul, Korea (the Republic of)
Heart. 2021 Mar;107(5):373-380. doi: 10.1136/heartjnl-2020-317901. Epub 2020 Dec 17.
Previous studies that evaluated cardiovascular risk factors considered age as a potential confounder. We aimed to investigate the impact of cardiovascular disease (CVD) and its risk factors on fatal outcomes according to age in patients with COVID-19.
A systematic literature review and meta-analysis was performed on data collected from PubMed and Embase databases up to 11 June 2020. All observational studies (case series or cohort studies) that assessed in-hospital patients were included, except those involving the paediatric population. Prevalence rates of comorbid diseases and clinical outcomes were stratified by mean patient age in each study (ranges: <50 years, 50-60 years and ≥60 years). The primary outcome measure was a composite fatal outcome of severe COVID-19 or death.
We included 51 studies with a total of 48 317 patients with confirmed COVID-19 infection. Overall, the relative risk of developing severe COVID-19 or death was significantly higher in patients with risk factors for CVD (hypertension: OR 2.50, 95% CI 2.15 to 2.90; diabetes: 2.25, 95% CI 1.89 to 2.69) and CVD (3.11, 95% 2.55 to 3.79). Younger patients had a lower prevalence of hypertension, diabetes and CVD compared with older patients; however, the relative risk of fatal outcomes was higher among the former.
The results of the meta-analysis suggest that CVD and its risk factors (hypertension and diabetes) were closely related to fatal outcomes in COVID-19 for patients across all ages. Although young patients had lower prevalence rates of cardiovascular comorbidities than elderly patients, relative risk of fatal outcome in young patients with hypertension, diabetes and CVD was higher than in elderly patients.
CRD42020198152.
既往评估心血管危险因素的研究将年龄视为潜在混杂因素。我们旨在研究心血管疾病（CVD）及其危险因素对新型冠状病毒肺炎（COVID-19）患者按年龄划分的致命结局的影响。
对截至2020年6月11日从PubMed和Embase数据库收集的数据进行系统文献综述和荟萃分析。纳入所有评估住院患者的观察性研究（病例系列或队列研究），但涉及儿科人群的研究除外。每项研究中按患者平均年龄对合并疾病的患病率和临床结局进行分层（范围：<50岁、50 - 60岁和≥60岁）。主要结局指标为重症COVID-19或死亡的综合致命结局。
我们纳入了51项研究，共48317例确诊COVID-19感染患者。总体而言，患有心血管疾病危险因素（高血压：比值比2.50，95%置信区间2.15至2.90；糖尿病：2.25，95%置信区间1.89至2.69）和心血管疾病（3.11，95%置信区间2.55至3.79）的患者发生重症COVID-19或死亡的相对风险显著更高。与老年患者相比，年轻患者高血压、糖尿病和心血管疾病的患病率较低；然而，前者的致命结局相对风险更高。
荟萃分析结果表明，心血管疾病及其危险因素（高血压和糖尿病）与各年龄段COVID-19患者的致命结局密切相关。尽管年轻患者心血管合并症的患病率低于老年患者，但患有高血压、糖尿病和心血管疾病的年轻患者的致命结局相对风险高于老年患者。
CRD42020198152。
