Department of Cardiothoracic Vascular Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, People's Republic of China.
Department of Pulmonary and Critical Care Medicine Intervention and Function, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, People's Republic of China.
BMC Cardiovasc Disord. 2024 Aug 5;24(1):407. doi: 10.1186/s12872-024-04086-5.
COVID-19 infections can result in severe acute respiratory distress syndrome (ARDS) requiring admission to the intensive care unit (ICU). Cardiovascular manifestation or exacerbation of cardiovascular diseases could be another complication. Cardiac arrhythmias including New-Onset Atrial Fibrillation (NOAF), have been observed in hospitalized patients with COVID-19 infections. In this analysis, we aimed to systematically compare the complications associated with NOAF in critically ill COVID-19 patients admitted to the ICU.
MEDLINE, EMBASE, Web of Science, the Cochrane database, http://www.
gov , Google Scholar and Mendeley were searched for relevant publications based on COVID-19 patients with NOAF admitted to the ICU. Complications including in-hospital mortality, ICU mortality, patients requiring mechanical ventilation, acute myocardial infarction, acute kidney injury, renal replacement therapy and pulmonary embolism were assessed. This is a meta-analysis and the analytical tool which was used was the RevMan software version 5.4. Risk ratios (RR) and 95% confidence intervals (CIs) were used to represent the data post analysis.
In critically ill COVID-19 patients with NOAF admitted to the ICU, the risks of ICU mortality (RR: 1.39, 95% CI: 1.07 - 1.80; P = 0.01), in-hospital mortality (RR: 1.56, 95% CI: 1.20 - 2.04; P = 0.001), patients requiring mechanical ventilation (RR: 1.32, 95% CI: 1.04 - 1.66; P = 0.02) were significantly higher when compared to the control group without AF. Acute myocardial infarction (RR: 1.54, 95% CI: 1.31 - 1.81; P = 0.00001), the risk for acute kidney injury (RR: 1.31, 95% CI: 1.11 - 1.55; P = 0.002) and patients requiring renal replacement therapy (RR: 1.83, 95% CI: 1.60 - 2.09; P = 0.00001) were also significantly higher in patients with NOAF.
Critically ill COVID-19 patients with NOAF admitted to the ICU were at significantly higher risks of developing complications and death compared to similar patients without AF.
COVID-19 感染可导致严重急性呼吸窘迫综合征（ARDS），需要入住重症监护病房（ICU）。心血管表现或心血管疾病恶化可能是另一种并发症。COVID-19 住院患者中观察到新发心房颤动（NOAF）等心律失常。在这项分析中，我们旨在系统比较 ICU 收治的 COVID-19 重症患者中与 NOAF 相关的并发症。
基于 COVID-19 合并 NOAF 入住 ICU 的患者，检索 MEDLINE、EMBASE、Web of Science、Cochrane 数据库、www.ClinicalTrials.gov、Google Scholar 和 Mendeley 等数据库中的相关文献。评估并发症包括院内死亡率、ICU 死亡率、需要机械通气的患者、急性心肌梗死、急性肾损伤、肾脏替代治疗和肺栓塞。这是一项荟萃分析，使用的分析工具是 RevMan 软件版本 5.4。分析后使用风险比（RR）和 95%置信区间（CI）表示数据。
在 ICU 收治的 COVID-19 合并 NOAF 的重症患者中，与对照组无 AF 患者相比，ICU 死亡率（RR：1.39，95%CI：1.07-1.80；P=0.01）、院内死亡率（RR：1.56，95%CI：1.20-2.04；P=0.001）、需要机械通气的患者（RR：1.32，95%CI：1.04-1.66；P=0.02）的风险显著更高。急性心肌梗死（RR：1.54，95%CI：1.31-1.81；P=0.00001）、急性肾损伤风险（RR：1.31，95%CI：1.11-1.55；P=0.002）和需要肾脏替代治疗的患者（RR：1.83，95%CI：1.60-2.09；P=0.00001）的风险也显著更高。
与无 AF 的类似患者相比，ICU 收治的 COVID-19 合并 NOAF 的重症患者发生并发症和死亡的风险明显更高。
