Rezler Zachary V, Ko Emma, Jin Elaine, Ishtiaq Misha, Papaioannou Christina, Kim Helena, Hwang Kyobin, Lin Yu-Hsin Sophy, Colautti Jake, Davison Karen M, Thakkar Vidhi
Bachelor of Health Sciences (Honours) Program, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Undergraduate Medical Education Program, Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
CJC Pediatr Congenit Heart Dis. 2022 Dec 1;2(1):33-50. doi: 10.1016/j.cjcpc.2022.11.005. eCollection 2023 Feb.
There is limited knowledge regarding the cardiovascular impact of coronavirus disease 2019 (COVID-19) on emerging adults aged 18-25, a group that disproportionately contracts COVID-19. To guide future cardiovascular disease (CVD) research, policy, and practice, a scoping review was conducted to: (i) examine the impact of the COVID-19 pandemic on the cardiovascular health of emerging adults; and (ii) identify strategies to screen for and manage COVID-19-related cardiovascular complications in this age group. A comprehensive search strategy was applied to several academic databases and grey literature sources. An updated search yielded 6738 articles, 147 of which were extracted and synthesized. Reports identified COVID-19-associated cardiac abnormalities, vascular alterations, and multisystem inflammatory syndrome in emerging adults; based on data from student-athlete samples, prevalence estimates of myocarditis and cardiac abnormalities were 0.5%-3% and 0%-7%, respectively. Obesity, hypertension, CVD, congenital heart disease, and marginalization are potential risk factors for severe COVID-19, related cardiovascular complications, and mortality in this age group. As a screening modality for COVID-19-associated cardiac involvement, it is recommended that cardiac magnetic resonance imaging be indicated by a positive cardiac history and/or abnormal "triad" testing (cardiac troponin, electrocardiogram, and transthoracic echocardiogram) to improve diagnostic utility. To foster long-term cardiovascular health among emerging adults, cardiorespiratory fitness, health literacy and education, and telehealth accessibility should be priorities of health policy and clinical practice. Ultimately, surveillance data from the broader emerging adult population will be crucial to assess the long-term cardiovascular impact of both COVID-19 infection and vaccination, guide screening and management protocols, and inform CVD prevention efforts.
关于2019冠状病毒病（COVID-19）对18至25岁青年成年人的心血管影响，目前了解有限，而这一年龄组感染COVID-19的比例过高。为指导未来的心血管疾病（CVD）研究、政策制定和实践，进行了一项范围综述，以：（i）研究COVID-19大流行对青年成年人心血管健康的影响；（ii）确定筛查和管理该年龄组与COVID-19相关心血管并发症的策略。将全面的检索策略应用于多个学术数据库和灰色文献来源。更新后的检索得到6738篇文章，其中147篇被提取并综合分析。报告指出青年成年人中存在与COVID-19相关的心脏异常、血管改变和多系统炎症综合征；根据学生运动员样本的数据，心肌炎和心脏异常的患病率估计分别为0.5%-3%和0%-7%。肥胖、高血压、心血管疾病、先天性心脏病和边缘化是该年龄组发生严重COVID-19、相关心血管并发症和死亡的潜在危险因素。作为COVID-19相关心脏受累的筛查方式，建议根据阳性心脏病史和/或异常的“三联”检查（心肌肌钙蛋白、心电图和经胸超声心动图）进行心脏磁共振成像，以提高诊断效用。为促进青年成年人的长期心血管健康，心肺适能、健康素养和教育以及远程医疗可及性应成为卫生政策和临床实践的重点。最终，来自更广泛青年成年人群体的监测数据对于评估COVID-19感染和疫苗接种的长期心血管影响、指导筛查和管理方案以及为心血管疾病预防工作提供信息至关重要。
