Rahmati Masoud, Koyanagi Ai, Banitalebi Ebrahim, Yon Dong Keon, Lee Seung Won, Il Shin Jae, Smith Lee
Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran.
Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain.
J Med Virol. 2023 Jan;95(1):e28325. doi: 10.1002/jmv.28325.
The longitudinal trajectories of cardiac structure and function following SARS-CoV-2 infection are unclear. Therefore, this meta-analysis aims to elucidate the effect of SARS-CoV-2 infection on cardiac function in coronavirus disease 2019 (COVID-19) survivors after recovery. PubMed/MEDLINE, CENTRAL, and EMBASE were systematically searched for articles published up to 1st August 2022. A systematic review and meta-analysis were performed to calculate the pooled effects size and 95% confidence interval of each outcome. A total of 21 studies including 2394 individuals (1436 post-COVID-19 cases and 958 controls) were included in the present meta-analysis. The pooled analyses compared with control groups showed a significant association between post-COVID-19 and reduced left ventricular ejection fraction (LV EF), LV end-diastolic volume (LV EDV), LV stroke volume (LV SV), mitral annular plane systolic excursion (MAPSE), global longitudinal strain, right ventricular EF (RV EF), RV EDV, RV ESV, RV SV, tricuspid annular plane systolic excursion, and increased LV mass. Subgroup analysis based on the severity of COVID-19 in the acute phase and subsequent chronic outcomes revealed that LV EF, MAPSE, RV EF, and RV ESV only decreased in studies including patients with a history of intensive care unit admission. Cardiac impairment after SARS-CoV-2 infection persisted in recovered COVID-19 patients even after 1 year. Future studies are warranted to determine the biological mechanisms underlying the long-term cardiovascular consequences of COVID-19.
新型冠状病毒2019（COVID-19）幸存者感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）后心脏结构和功能的纵向轨迹尚不清楚。因此，本荟萃分析旨在阐明SARS-CoV-2感染对COVID-19康复幸存者心脏功能的影响。我们系统检索了PubMed/MEDLINE、CENTRAL和EMBASE数据库中截至2022年8月1日发表的文章。进行了一项系统评价和荟萃分析，以计算每个结局的合并效应量和95%置信区间。本荟萃分析共纳入21项研究，包括2394名个体（1436例COVID-19后病例和958名对照）。与对照组相比的汇总分析显示，COVID-19后与左心室射血分数（LV EF）降低、左心室舒张末期容积（LV EDV）降低、左心室每搏输出量（LV SV）降低、二尖瓣环平面收缩期位移（MAPSE）降低、整体纵向应变降低、右心室射血分数（RV EF）降低、右心室舒张末期容积（RV EDV）降低、右心室收缩末期容积（RV ESV）降低、右心室每搏输出量降低、三尖瓣环平面收缩期位移降低以及左心室质量增加显著相关。基于急性期COVID-19严重程度和随后慢性结局的亚组分析显示，仅在纳入有重症监护病房住院史患者的研究中，LV EF、MAPSE、RV EF和RV ESV降低。SARS-CoV-2感染后的心脏损害在康复的COVID-19患者中持续存在，即使在1年后也是如此。有必要开展进一步研究以确定COVID-19长期心血管后果的生物学机制。
