El-Qushayri Amr Ehab, Dahy Abdullah, Benmelouka Amira Yasmine, Kamel Ahmed Mostafa Ahmed
Faculty of Medicine, Minia University, Minia, Egypt.
Faculty of Medicine, University of Algiers, Algeria.
Am J Med Open. 2023 Jun;9:100032. doi: 10.1016/j.ajmo.2023.100032. Epub 2023 Jan 18.
We aimed to study the effect of COVID-19 on the in-hospital outcomes of percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS).
A systematic literature search was performed in 2nd February 2022 updated in 12th December 2022 for recruiting relevant papers. The effect size was computed via the odds ratio (OR) for dichotomous data or standardized mean difference (SMD) for continuous data along with the 95% confidence interval (95%CI).
After the screening of 1075 records, we found 11 relevant papers that included 2018 COVID-19 patients and negative controls 21,207. ACS patients with COVID-19 had a significant higher mortality rate (OR: 4.95; 95%CI: 3.92-6.36; <0.01), long hospital stay (days) (SMD: 1.17; 95%CI: 0.92-1.42; <0.01), and reduced post TIMI 3 score (OR: 0.55; 95%CI: 0.41-0.73; <0.01) rather than controls. However, we found no significant differences in terms of thrombus aspiration prevalence (OR: 1.88; 95%CI: 0.97-3.65; = 0.06) or door to balloon time (SMD: 0.11; 95%CI: -0.43-0.66; = 0.7).
Despite that we found a significant association between COVID-19 and high mortality, more length of hospital stay and reduced post TIMI 3 score, in ACS patients after PCI, a rigorous analysis of the adjusted hazard ratio -that was absent in most of the included studies- by further meta-analysis is recommended to confirm this association. However, close monitoring of COVID-19 in patients with a high risk of developing ACS, is recommended due to the associated hypercoagulability of COVID-19 infection.
我们旨在研究新型冠状病毒肺炎（COVID-19）对急性冠状动脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）院内结局的影响。
于2022年2月2日进行系统文献检索，并于2022年12月12日更新，以纳入相关论文。效应量通过二分类数据的比值比（OR）或连续数据的标准化均数差（SMD）以及95%置信区间（95%CI）计算。
在筛选1075条记录后，我们发现11篇相关论文，其中包括2018例COVID-19患者和21207例阴性对照。患有COVID-19的ACS患者的死亡率显著更高（OR：4.95；95%CI：3.92 - 6.36；P<0.01），住院时间更长（天）（SMD：1.17；95%CI：0.92 - 1.42；P<0.01），且心肌梗死溶栓试验（TIMI）3级血流后评分降低（OR：0.55；95%CI：0.41 - 0.73；P<0.01），与对照组相比差异显著。然而，我们发现血栓抽吸发生率（OR：1.88；95%CI：0.97 - 3.65；P = 0.06）或门球时间（SMD：0.11；95%CI： - 0.43 - 0.66；P = 0.7）方面无显著差异。
尽管我们发现COVID-19与高死亡率、更长住院时间以及PCI术后ACS患者TIMI 3级血流后评分降低之间存在显著关联，但由于大多数纳入研究中缺乏对调整后风险比的严格分析，建议通过进一步的荟萃分析来证实这种关联。然而，鉴于COVID-19感染相关的高凝状态，建议对具有发生ACS高风险的患者密切监测COVID-19。
