Hatmi Zinat Nadia
Department of preventive medicine, Medical school, Tehran University of Medical Sciences, Purcina Ave, Medical Faculty, Building No 4, Second floor, Tehran, Iran.
Department of Epidemiology, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
SN Compr Clin Med. 2021;3(2):419-436. doi: 10.1007/s42399-021-00749-y. Epub 2021 Jan 26.
COVID-19 a systemic inflammation involving multiple organs, affecting all age groups, with high mortality rate, severe adverse outcomes, and high economic burden need to be described. A systematic review of systematic reviews conducted. We searched PubMed, OVID Medline, Cochrane library, COVID-19 resource centers of N Engl. J Med, AHA, and LITCOVID. Certainty of evidences was evaluated by GRADE approach. Meta-analysis according to random effects model was conducted. Seventy-one eligible systematic reviews are included in the study. A total of 86.5% of them had high quality, and 13.5% had medium quality. Meta-analysis results are presented in tabular format, and the remaining results are presented in narration fashion. COVID-19 involves blood vessels, lung, heart, nervous system, liver, gastrointestinal system, kidney, eyes, and other organs and infects adult and children, neonates, pregnant women, and elderly, transmitted via air born and droplet. Comorbidities associated with COVID-19 are HTN 20.7%, CVD 9.6%, DM 9.55%, respiratory diseases 7%, and 9% of cigarette smoking. Prognostic factors for mortality among COVID-19 cases are acute cardiac injury, diagnosed CVD, DM, respiratory disease, and HTN. Prognostic factors for disease severity are CVD and HTN. Prognostic factors for disease progression were fever, shortness of breath, and smoking. There is no specific antiviral treatment. Preventive measures including physical distancing of 2 m and more, using PPE, avoiding social gatherings, quarantine, and isolation have been recommended. Encouraging telemedicine, online training, and homeschooling are highly recommended. Vaccine is approaching, and concerns exist about vaccine with a high efficacy. Modification of CVD and cardiometabolic risk became the cornerstone for sustainable control of pandemic.
需要描述的是，新型冠状病毒肺炎（COVID-19）是一种涉及多个器官的全身性炎症，影响所有年龄组，死亡率高，有严重不良后果且经济负担沉重。我们进行了一项系统评价的系统综述。我们检索了PubMed、OVID医学数据库、Cochrane图书馆、《新英格兰医学杂志》、美国心脏协会（AHA）和LITCOVID的COVID-19资源中心。采用GRADE方法评估证据的确定性。根据随机效应模型进行荟萃分析。该研究纳入了71篇符合条件的系统综述。其中86.5%质量高，13.5%质量中等。荟萃分析结果以表格形式呈现，其余结果以叙述方式呈现。COVID-19累及血管、肺、心脏、神经系统、肝脏、胃肠道系统、肾脏、眼睛和其他器官，感染成人、儿童、新生儿、孕妇和老年人，通过空气传播和飞沫传播。与COVID-19相关的合并症包括高血压（20.7%）、心血管疾病（9.6%）、糖尿病（9.55%）、呼吸系统疾病（7%）以及9%的吸烟人群。COVID-19病例死亡的预后因素是急性心脏损伤、确诊的心血管疾病、糖尿病、呼吸系统疾病和高血压。疾病严重程度的预后因素是心血管疾病和高血压。疾病进展的预后因素是发热、呼吸急促和吸烟。目前尚无特异性抗病毒治疗方法。已推荐采取包括保持2米及以上的物理距离、使用个人防护装备、避免社交聚会、检疫和隔离等预防措施。强烈建议鼓励远程医疗、在线培训和在家上学。疫苗即将问世，人们对高效疫苗存在担忧。改善心血管疾病和心脏代谢风险成为可持续控制疫情的基石。
