Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
Am J Emerg Med. 2021 Oct;48:128-139. doi: 10.1016/j.ajem.2021.04.013. Epub 2021 Apr 20.
With the continuance of the global COVID-19 pandemic, cardiovascular disease (CVD) and cardiac injury have been suggested to be risk factors for severe COVID-19.
The aim is to evaluate the mortality risks associated with CVD and cardiac injury among hospitalized COVID-19 patients, especially in subgroups of populations in different countries.
A comprehensive systematic literature search was performed using 9 databases from November 1, 2019 to November 9, 2020. Meta-analyses were performed for CVD and cardiac injury between non-survivors and survivors of COVID-19.
Although the prevalence of CVD in different populations was different, hospitalized COVID-19 patients with CVD were at a higher risk of fatal outcomes (OR = 2.72; 95% CI 2.35-3.16) than those without CVD. Separate meta-analyses of populations in four different countries also reached a similar conclusion that CVD was associated with an increase in mortality. Cardiac injury was common among hospitalized COVID-19 patients. Patients with cardiac injury had a significantly higher mortality risk than those without cardiac injury (OR = 13.25; 95% CI: 8.56-20.52).
Patients' CVD history and biomarkers of cardiac injury should be taken into consideration during the hospital stay and incorporated into the routine laboratory panel for COVID-19.
随着全球 COVID-19 大流行的持续，心血管疾病（CVD）和心脏损伤已被认为是 COVID-19 重症的危险因素。
本研究旨在评估 COVID-19 住院患者中 CVD 和心脏损伤与死亡率的相关性，尤其是在不同国家人群亚组中的相关性。
从 2019 年 11 月 1 日至 2020 年 11 月 9 日，我们使用 9 个数据库进行了全面的系统文献检索。对 COVID-19 非幸存者和幸存者之间的 CVD 和心脏损伤进行了荟萃分析。
尽管不同人群 CVD 的患病率不同，但患有 CVD 的 COVID-19 住院患者发生致命结局的风险更高（OR=2.72；95%CI 2.35-3.16），而无 CVD 的 COVID-19 住院患者风险较低。对来自四个不同国家的人群进行的单独荟萃分析也得出了类似的结论，即 CVD 与死亡率增加相关。心脏损伤在 COVID-19 住院患者中很常见。与无心脏损伤的患者相比，有心脏损伤的患者死亡率显著升高（OR=13.25；95%CI：8.56-20.52）。
在住院期间应考虑患者的 CVD 病史和心脏损伤的生物标志物，并将其纳入 COVID-19 的常规实验室检测项目中。
