新型冠状病毒肺炎与心脏损伤相关性的Meta分析

Meta Analysis of the Correlation between COVID-19 and Heart Injury

摘要: 目的：通过meta分析评价新型冠状病毒肺炎与心脏损伤的相关性，为临床提供循证依据。方法：计算机检索万方、知网、中国生物医学文献数据库、PubMed、Embase、Cochrane Library、Medline数据库，检索感染新型冠状病毒肺炎与心脏损伤的相关研究，检索时间区间均从2020年1月1日至2020年4月20日。对于纳入的研究，应用Rev Man5.3及STATA软件进行分析。结果：总共纳入29项研究，合计4466名患者。Meta分析结果示：危重型患者比非危重型患者有更高的肌钙蛋白(p = 0.03)；合并心肌损伤的患者病情更重、死亡率更高(p = 0.002; p < 0.0001)；此外，患有冠心病、糖尿病或高血压的患者感染新型冠状病毒肺炎后比普通人群感染后病情更重，死亡率更高(p < 0.01)；CK-MB、AST、肌红蛋白、NT-proBNP也对判断病情严重程度有一定价值。结论：合并心脏损伤的新冠肺炎患者病情更重、死亡率更高，且患有基础疾病也能加重病情、提高死亡率。

Abstract: AIM: To evaluate the correlation between COVID-19 and heart injury through meta analysis, and to provide evidence-based basis for clinical practice. Methods: Wanfang, CNKI, Chinese biomedical literature database, PubMed, Embase, Cochrane Library, Medline database were searched by computer to retrieve studies related to COVID-19 infection and heart injury. The search time ranges from January 1, 2020 to April 20, 2020. Rev Man5.3 and STATA software were used to analyze the included studies. Results: A total of 29 studies were included, totaling 4466 patients. The results of the meta analysis showed that the critically ill patients had higher troponin than the non-critical patients (p = 0.03); the patients with myocardial injury were more serious and had higher mortality (p = 0.002; p = 0.0001); furthermore, patients with coronary heart disease, diabetes, or high blood pressure have more severe and higher mortality rates after infection with COVID-19 (p < 0.01); CK-MB, AST, MYO, NT-proBNP also had some value in judging the severity of the disease. Conclusion: The COVID-19 patients with heart injury are more serious, and have a higher mortality rate, and having basic diseases can also aggravate the condition and increase the mortality rate.