Dehghan Mahshid, Mirzohreh Seyedeh-Tarlan, Kaviani Raheleh, Yousefi Shiva, Pourmehran Yasaman
Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Shahid Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Front Cardiovasc Med. 2024 Nov 19;11:1458389. doi: 10.3389/fcvm.2024.1458389. eCollection 2024.
The COVID-19 pandemic has challenged global health systems since December 2019, with the novel virus SARS-CoV-2 causing multi-systemic disease, including heart complications. While acute cardiac effects are well-known, long-term implications are understudied. This review hopes to fill a gap in the literature and provide valuable insights into the long-term cardiac consequences of the virus, which can inform future public health policies and clinical practices.
This systematic review was prepared using PRISMA reporting guidelines. The databases searched were PubMed, Scopus, Web of Science, and Cochrane. Risk of Bias was assessed using ROBINS-I. The GRADE approach was employed to evaluate the level of certainty in the evidence for each outcome. A meta-analysis was conducted using the Comprehensive Meta-Analysis (CMA) software. In order to identify the underlying cause of high heterogeneity, a subgroup analysis was conducted. Sensitivity analysis was checked.
Sixty-six studies were included in this review. Thirty-two of them enrolled in meta-analysis and the rest in qualitative synthesis. Most outcomes showed a moderate certainty of evidence according to the GRADE framework. Post-COVID individuals with no prior heart diseases showed significant changes in left ventricular (LV) and right ventricular (RV) echocardiographic indices compared to controls. These significant findings were seen in both post-acute and long-COVID survivors regardless of the severity of initial infection.
This review implies that individuals recovering from post-acute and long-term effects of COVID-19 may experience changes in myocardial function as a result of the novel coronavirus. These changes, along with cardiac symptoms, have been observed in patients without prior heart diseases or comorbidities.
PROSPERO, identifier (CRD42024481337).
自2019年12月以来，新冠疫情对全球卫生系统构成了挑战，新型冠状病毒SARS-CoV-2引发了多系统疾病，包括心脏并发症。虽然急性心脏影响已为人所知，但长期影响仍研究不足。本综述旨在填补文献空白，为该病毒的长期心脏后果提供有价值的见解，为未来的公共卫生政策和临床实践提供参考。
本系统综述采用PRISMA报告指南编写。检索的数据库包括PubMed、Scopus、科学网和Cochrane。使用ROBINS-I评估偏倚风险。采用GRADE方法评估每个结果证据的确定性水平。使用综合荟萃分析（CMA）软件进行荟萃分析。为了确定高异质性的潜在原因，进行了亚组分析。检查了敏感性分析。
本综述纳入了66项研究。其中32项纳入荟萃分析，其余纳入定性综合分析。根据GRADE框架，大多数结果显示证据的确定性为中等。与对照组相比，既往无心脏病的新冠康复者左心室（LV）和右心室（RV）超声心动图指标有显著变化。无论初始感染的严重程度如何，在急性感染后和长期新冠幸存者中均观察到这些显著发现。
本综述表明，从新冠急性感染和长期影响中康复的个体可能会因新型冠状病毒而出现心肌功能变化。这些变化以及心脏症状在既往无心脏病或合并症的患者中也有观察到。
PROSPERO，标识符（CRD42024481337）。
