CardioEco Centro de Diagnóstico Cardiovascular, Curitiba, PR - Brasil.
Quanta Diagnóstico, Ecocardiografia,Curitiba, PR - Brasil.
Arq Bras Cardiol. 2022 Aug;119(2):267-279. doi: 10.36660/abc.20210485.
Coronavirus disease 2019 (Covid-19) can lead to severe respiratory distress and acute cardiac injury, but it is unclear how often it can cause cardiac dysfunction.
In this systematic review, we aimed to summarize the main echocardiographic findings in patients with Covid-19.
We systematically searched in PUBMED, EMBASE, LILACS and Cochrane databases, in addition MedRxiv and Scielo preprints from inception to July 21st, 2021. Studies reporting echocardiographic data in patients with Covid-19 were included. Demographic characteristics, previous cardiovascular disease (CVD), and echocardiographic findings were extracted. We performed a meta-analysis of proportions to estimate the main echocardiographic findings. The level of significance was p < 0.05.
From 11,233 studies, 38 fulfilled inclusion criteria and were included in the meta-analysis. The estimated proportions of left ventricular (LV) systolic dysfunction were 25% (95%CI: 19, 31; I293%), abnormal global longitudinal strain 34% (95% CI 23, 45; I290%), righ ventricular (RV) systolic dysfunction 17% (95%CI 13, 21; I290%), pericardial effusion 17% (95%CI: 9, 26; I297%), and pulmonary hypertension 23% (95%CI: 15, 33, I2 96%). LV systolic dysfunction was directly associated with study-specific prevalence of previous abnormal echocardiogram (p<0.001). The proportion of patients in mechanical ventilation, indicating severity of disease, did not explain the heterogeneity in the proportions of LV dysfunction (p=0.37).
Among hospitalized patients with Covid-19, LV dysfunction has been reported in one quarter, with smaller proportions of right ventricular dysfunction, pericardial effusion and pulmonary hypertension. However, there was a higher proportion of LV dysfunction among studies reporting the presence of prior heart disease, which suggests that cardiac dysfunction was mostly pre-existing.
2019 年冠状病毒病（Covid-19）可导致严重的呼吸窘迫和急性心脏损伤，但尚不清楚它会导致心脏功能障碍的频率。
在这项系统评价中，我们旨在总结患有 Covid-19 的患者的主要超声心动图表现。
我们系统地在 PUBMED、EMBASE、LILACS 和 Cochrane 数据库中进行了检索，此外还在 MedRxiv 和 Scielo 预印本中进行了检索，检索时间从成立到 2021 年 7 月 21 日。纳入了报告 Covid-19 患者超声心动图数据的研究。提取了人口统计学特征、先前的心血管疾病（CVD）和超声心动图结果。我们对比例进行了荟萃分析，以估计主要的超声心动图发现。显著性水平为 p < 0.05。
从 11233 项研究中，有 38 项符合纳入标准并纳入荟萃分析。左心室（LV）收缩功能障碍的估计比例为 25%（95%CI：19，31；I293%），整体纵向应变异常为 34%（95%CI：23，45；I290%），右心室（RV）收缩功能障碍为 17%（95%CI：13，21；I290%），心包积液为 17%（95%CI：9，26；I297%），肺动脉高压为 23%（95%CI：15，33，I296%）。LV 收缩功能障碍与研究特异性的先前异常超声心动图患病率直接相关（p<0.001）。机械通气患者的比例，表明疾病的严重程度，不能解释 LV 功能障碍比例的异质性（p=0.37）。
在住院的 Covid-19 患者中，LV 功能障碍的报告比例为四分之一，RV 功能障碍、心包积液和肺动脉高压的比例较小。然而，在报告存在先前心脏病的研究中，LV 功能障碍的比例较高，这表明心脏功能障碍主要是预先存在的。
