Jewbali L S D, Hoogervorst-Schilp J, Belfroid E, Jansen C W, Asselbergs F W, Siebelink H J
Department of Cardiology and Intensive Care Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
Knowledge Institute of Medical Specialists, Utrecht, The Netherlands.
Neth Heart J. 2021 May;29(Suppl 1):13-19. doi: 10.1007/s12471-021-01572-9. Epub 2021 Apr 16.
Hospitalised COVID-19 patients with underlying cardiovascular disease (CVD) and cardiovascular risk factors appear to be at risk of poor outcome. It is unknown if these patients should be considered a vulnerable group in healthcare delivery and healthcare recommendations during the COVID-19 pandemic.
A systematic literature search was performed to answer the following question: In which hospitalised patients with proven COVID-19 and with underlying CVD and cardiovascular risk factors should doctors be alert to a poor outcome? Relevant outcome measures were mortality and intensive care unit admission. Medline and Embase databases were searched using relevant search terms until 9 June 2020. After systematic analysis, 8 studies were included.
Based on the literature search, there was insufficient evidence that CVD and cardiovascular risk factors are significant predictors of mortality and poor outcome in hospitalised patients with COVID-19. Due to differences in methodology, the level of evidence of all studies was graded 'very low' according to the Grading Recommendations Assessment, Development and Evaluation methodology. It is expected that in the near future, two multinational and multicentre European registries (CAPACITY-COVID and LEOSS) will offer more insight into outcome in COVID-19 patients.
This literature review demonstrated there was insufficient evidence to identify CVD and cardiovascular risk factors as important predictors of poor outcome in hospitalised COVID-19 patients. However, patients with CVD and cardiovascular risk factors remain vulnerable to infectious disease outbreaks. As such, governmental and public health COVID-19 recommendations for vulnerable groups apply to these patients.
患有基础心血管疾病（CVD）和心血管危险因素的COVID-19住院患者似乎预后不良风险较高。在COVID-19大流行期间的医疗服务和医疗建议中，这些患者是否应被视为弱势群体尚不清楚。
进行了系统的文献检索，以回答以下问题：对于哪些确诊COVID-19且患有基础CVD和心血管危险因素的住院患者，医生应警惕预后不良？相关结局指标为死亡率和入住重症监护病房情况。使用相关检索词对Medline和Embase数据库进行检索，截至2020年6月9日。经过系统分析，纳入了8项研究。
基于文献检索，没有足够的证据表明CVD和心血管危险因素是COVID-19住院患者死亡率和不良结局的重要预测因素。由于方法上的差异，根据分级推荐评估、发展和评价方法，所有研究的证据水平均被评为“极低”。预计在不久的将来，两项欧洲多国多中心注册研究（CAPACITY-COVID和LEOSS）将提供更多关于COVID-19患者结局的见解。
这篇文献综述表明，没有足够的证据将CVD和心血管危险因素确定为COVID-19住院患者不良结局的重要预测因素。然而，患有CVD和心血管危险因素的患者仍然容易受到传染病暴发的影响。因此，政府和公共卫生部门针对弱势群体的COVID-19建议适用于这些患者。
