Right Ventricular Dysfunction in Patients With COVID-19: A Systematic Review and Meta-analysis.
Right Ventricular Dysfunction in Patients With COVID-19: A Systematic Review and Meta-analysis.
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DOI：
10.1053/j.jvca.2021.04.008
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发表时间：
2021-11
影响因子：
2.8
通讯作者：
Guarracino F
中科院分区：
文献类型：
--
作者：
Paternoster G;Bertini P;Innelli P;Trambaiolo P;Landoni G;Franchi F;Scolletta S;Guarracino F
本系统综述和荟萃分析旨在描述冠状病毒病（COVID-19）中右心室损害和肺动脉高压的特征，并评估其对死亡率的影响。作者对观察性研究进行了系统回顾和荟萃分析。作者通过PubMed、国际临床试验注册平台和科克伦图书馆检索了报告COVID-19患者右心室功能障碍的研究及其结局。检索得到了9项研究，其中有适当的数据。干预措施：根据随机效应模型计算合并比值比。总体而言，分析了1，450名患者，其中一半接受了有创通气。主要结局是最长随访时的死亡率。死亡率为48.5%，而有或无右心室损害的患者死亡率为24.7（n = 7; OR = 3.10; 95%置信区间[CI] 1.72-5.58; p = 0.0002），56.3% vs 30.6%，伴或不伴右心室扩张的患者（n = 6; OR = 2.43; 95%CI 1.41-4.18; p = 0.001），有或无肺动脉高压的患者为52.9% vs 14.8%（n = 3; OR = 5.75; 95%CI 2.67-12.38; p < 0.001）。需要呼吸支持并诊断为右心室功能障碍、扩张或肺动脉高压的COVID-19患者的死亡率很高。未来的研究应该强调COVID-19右心室紊乱的机制，使用超声早期检测右心室损伤对于个体化治疗和改善结局可能很重要。
This systematic review and meta-analysis aimed to describe the features of right ventricular impairment and pulmonary hypertension in coronavirus disease (COVID-19) and assess their effect on mortality. The authors carried out a systematic review and meta-analysis of observational studies. The authors performed a search through PubMed, the International Clinical Trials Registry Platform, and the Cochrane Library for studies reporting right ventricular dysfunction in patients with COVID-19 and outcomes. The search yielded nine studies in which the appropriate data were available. Interventions: Pooled odds ratios were calculated according to the random-effects model. Overall, 1,450 patients were analyzed, and half of them were invasively ventilated. Primary outcome was mortality at the longest follow-up available. Mortality was 48.5% versus 24.7% in patients with or without right ventricular impairment (n = 7; OR = 3.10; 95% confidence interval [CI] 1.72-5.58; p = 0.0002), 56.3% versus 30.6% in patients with or without right ventricular dilatation (n = 6; OR = 2.43; 95% CI 1.41-4.18; p = 0.001), and 52.9% versus 14.8% in patients with or without pulmonary hypertension (n = 3; OR = 5.75; 95% CI 2.67-12.38; p < 0.001). Mortality in patients with COVID-19 requiring respiratory support and with a diagnosis of right ventricular dysfunction, dilatation, or pulmonary hypertension is high. Future studies should highlight the mechanisms of right ventricular derangement in COVID-19, and early detection of right ventricular impairment using ultrasound might be important to individualize therapies and improve outcomes.
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DOI：
10.1186/s13054-020-03385-5
发表时间：
2020-11-30
期刊：
Critical care (London, England)
影响因子：
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作者：
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影响因子：
2.8
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期刊：
The Lancet. Respiratory medicine
影响因子：
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DOI：
10.1111/echo.14837
发表时间：
2020-08-29
影响因子：
1.5
作者：
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通讯作者：
Baranda-Tovar, Francisco
DOI：
10.1016/s0140-6736(20)32008-0
发表时间：
2020-10-10
期刊：
Lancet (London, England)
影响因子：
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作者：
Barbaro RP;MacLaren G;Boonstra PS;Iwashyna TJ;Slutsky AS;Fan E;Bartlett RH;Tonna JE;Hyslop R;Fanning JJ;Rycus PT;Hyer SJ;Anders MM;Agerstrand CL;Hryniewicz K;Diaz R;Lorusso R;Combes A;Brodie D;Extracorporeal Life Support Organization
通讯作者：
Extracorporeal Life Support Organization