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与普通肺炎不同,新冠病毒病是多种心血管疾病的一个风险因素:一项两样本孟德尔随机化研究。

Unlike common pneumonia, COVID-19 is a risk factor for multiple cardiovascular diseases: A two-sample Mendelian randomization study.

作者信息

Li Chengjia, Chen Huijun

机构信息

Heilongjiang University of Chinese Medicine, Harbin, China.

Heilongjiang University of Chinese Medicine affiliated second hospital, Harbin, China.

出版信息

Medicine (Baltimore). 2024 Dec 27;103(52):e41015. doi: 10.1097/MD.0000000000041015.

Abstract

This study investigates the differences between COVID-19 and past common forms of pneumonia and to determine if COVID-19 acts as a contributing factor in various cardiovascular diseases (CVDs). We retrieved large-sample genome-wide association study data from the Open GWAS database related to COVID-19, bacterial pneumonia (BP), viral pneumonia (VP), stable angina (SA), unstable angina (UA), heart failure (HF), ischemic heart disease (IHD), atrial fibrillation (AF), and myocardial infarction (MI). We selected single-nucleotide polymorphisms with strong correlations as instrumental variables (P < 5E-06), and set the threshold for the F-statistic to be over 10. Five statistical methods were used for analysis including inverse variance weighted, Mendelian randomization-Egger, weighted median, simple mode, and weighted mode, with inverse variance weighted as the primary method. We assessed the reliability of our results through heterogeneity, pleiotropy, and sensitivity testing; Our analysis probed the relationship between COVID-19, BP, VP, and 6 CVDs. COVID-19 infection was found to enhance the incidence of SA, UA, HF, and MI (SA: odds ratio [OR], 1.12; 95% confidence interval [CI], 1.04-1.20; P = .002; UA: OR, 1.14; 95% CI, 1.01-1.29; P = .041; HF: OR, 1.12; 95% CI, 1.03-1.23; P = .012; MI: OR, 1.11; 95% CI, 1.02-1.25; P = .032). There was no significant effect on the incidence of AF or IHD (P > .05), and no pleiotropy or sensitivity issues were found in the results. In contrast, neither past common BP nor VP was found to contribute to the progression of these 6 CVDs (P > .05). Unlike past common BP or VP, COVID-19 was found to increase the risks of SA, UA, HF, and MI, with no evidence supporting an increased risk for AF or IHD following COVID-19 infection.

摘要

本研究调查了新型冠状病毒肺炎(COVID-19)与过去常见肺炎形式之间的差异,并确定COVID-19是否为各种心血管疾病(CVD)的一个促成因素。我们从开放全基因组关联研究(Open GWAS)数据库中检索了与COVID-19、细菌性肺炎(BP)、病毒性肺炎(VP)、稳定型心绞痛(SA)、不稳定型心绞痛(UA)、心力衰竭(HF)、缺血性心脏病(IHD)、心房颤动(AF)和心肌梗死(MI)相关的大样本全基因组关联研究数据。我们选择具有强相关性的单核苷酸多态性作为工具变量(P < 5E-06),并将F统计量的阈值设定为超过10。使用了五种统计方法进行分析,包括逆方差加权法、孟德尔随机化-伊格尔法、加权中位数法、简单模式法和加权模式法,以逆方差加权法作为主要方法。我们通过异质性、多效性和敏感性检验评估结果的可靠性;我们的分析探究了COVID-19、BP、VP与6种CVD之间的关系。发现COVID-19感染会增加SA、UA、HF和MI的发病率(SA:优势比[OR],1.12;95%置信区间[CI],1.04 - 1.20;P = 0.002;UA:OR,1.14;95% CI,1.01 - 1.29;P = 0.041;HF:OR,1.12;95% CI,1.03 - 1.23;P = 0.012;MI:OR,1.11;95% CI,1.02 - 1.25;P = 0.032)。对AF或IHD的发病率没有显著影响(P > 0.05),并且在结果中未发现多效性或敏感性问题。相比之下,未发现过去常见的BP或VP会促成这6种CVD的进展(P > 0.05)。与过去常见的BP或VP不同,发现COVID-19会增加SA、UA、HF和MI的风险,没有证据支持COVID-19感染后AF或IHD的风险增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5b3/11688020/4b45ba4c05b5/medi-103-e41015-g001.jpg

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