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2020 ; 72
(1
): 41
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Cardiovascular disease in COVID-19: a systematic review and meta-analysis of
10,898 patients and proposal of a triage risk stratification tool
#MMPMID32661796
Momtazmanesh S
; Shobeiri P
; Hanaei S
; Mahmoud-Elsayed H
; Dalvi B
; Malakan Rad E
Egypt Heart J
2020[Jul]; 72
(1
): 41
PMID32661796
show ga
BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic has drastically affected
global health. Despite several studies, there is yet a dearth of data regarding
the mechanisms of cardiac injury, clinical presentation, risk factors, and
treatment of COVID-19-associated cardiovascular disease. This systematic review
and meta-analysis is aimed at defining the clinical, electrocardiographic, and
pathologic spectrum of cardiovascular disease (CVD), frequency of elevated
cardiac and inflammatory biomarkers, and their frequency and relationship with
severity of the disease and mortality in COVID-19 patients and to develop a
triage risk stratification tool (TRST) that can serve as a guide for the timely
recognition of the high-risk patients and mechanism-targeted therapy. We
conducted an online search in databases of PubMed and Embase to identify relevant
studies. Data selection was in concordance with PRISMA guidelines. Results were
presented as pooled frequencies, odds ratio, standardized mean difference (SMD),
and forest and funnel plots. RESULTS: We gathered a total of 54 studies and
included 35 of them in our meta-analysis. Acute cardiac injury occurred in more
than 25% of cases, mortality was 20 times higher, and admission to intensive care
unit increased by 13.5 times. Hypertension was the most common pre-existing
comorbidity with a frequency of 29.2%, followed by diabetes mellitus (13.5%). The
deceased group of patients had higher cardiac and inflammatory biomarkers, with
statistically significant SMD, compared with survivors. Pediatric patients were
predominantly mildly affected. However, less frequently, the presentation was
very similar to Kawasaki disease or Kawasaki shock syndrome. This latter
presentation hass been called as multisystem inflammatory syndrome in children
(MIS-C). CONCLUSIONS: There is a wide spectrum of cardiac involvement in COVID-19
patients, and hence a Triage Risk Stratification Tool can serve as a guide for
the timely recognition of the high-risk patients and mechanism-targeted therapy.