Zuin Marco, Rigatelli Gianluca, Bilato Claudio, Zuliani Giovanni, Roncon Loris
Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
Department of Cardiology, Santa Maria della Misericordia Hospital, Rovigo, Italy.
Acta Cardiol. 2022 Apr;77(2):107-113. doi: 10.1080/00015385.2021.1890925. Epub 2021 Jun 3.
BACKGROUND/OBJECTIVES: The prevalence and prognostic implications of heart failure (HF), as a complication of COVID-19 infection remains unclear. We performed a systematic review and metanalysis aimed to evaluate the pooled incidence of acute HF as a cardiac complication of COVID-19 disease and to estimate the related mortality risk in these patients.
Data were obtained searching MEDLINE, Scopus and Web of Science for all investigations published any time to 26 December 2020. If statistical heterogeneity was 50%, the results were derived from the fixed-effects model otherwise the random-effects model.
Overall, 1064 patients [mean age 66 years, 618 males] were included in the final analysis reviewing six investigations. The cumulative in-hospital rate of COVID-19 patients complicated by acute HF ranged between 6.9 and 63.4% among the studies reviewed. A random effect model revealed a pooled incidence of COVID-19 patients complicated by acute HF in 20.2% of cases (95% CI: 11.1-33.9%, < 0.0001 I2 = 94.4%). A second pooled analysis, based on a random-effect model, confirmed a significant increased risk of death in COVID-19 patients complicated by acute HF during the infection (OR 9.36, 95% CI 4.76-18.4, < 0.0001, I2 = 56.6%). Meta-regression analysis, using age as moderator variable, failed in founding a statistically significant relationship with the incidence of acute HF onset as a complication of COVID-19 disease ( = 0.062) or the mortality risk among the same subjects ( = 0.053).
Acute HF represents a frequent complication of COVID-19 infection associated with a higher risk of mortality in the short-term period.
背景/目的：作为新型冠状病毒肺炎（COVID-19）感染的一种并发症，心力衰竭（HF）的患病率及其预后影响仍不明确。我们进行了一项系统评价和荟萃分析，旨在评估急性HF作为COVID-19疾病心脏并发症的合并发病率，并估计这些患者的相关死亡风险。
通过检索MEDLINE、Scopus和Web of Science获取截至2020年12月26日发表的所有研究数据。如果统计异质性为50%，则结果来自固定效应模型，否则采用随机效应模型。
最终分析纳入了6项研究中的1064例患者[平均年龄66岁，男性618例]。在纳入综述的研究中，COVID-19患者并发急性HF的累积住院率在6.9%至63.4%之间。随机效应模型显示，20.2%的COVID-19患者并发急性HF（95%置信区间：11.1%-33.9%，P<0.0001，I²=94.4%）。基于随机效应模型的第二项荟萃分析证实，COVID-19患者在感染期间并发急性HF时死亡风险显著增加（比值比9.36，95%置信区间4.76-18.4，P<0.0001，I²=56.6%）。以年龄作为调节变量的Meta回归分析未能发现与COVID-19疾病并发症急性HF发作的发生率（P=0.062）或同一受试者的死亡风险（P=0.053）存在统计学显著关系。
急性HF是COVID-19感染的常见并发症，在短期内死亡风险较高。
