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Abstract：
To explore the correlation between cardiac-related comorbidities, cardiac biomarkers, acute myocardial injury, and severity level, outcomes in COVID-19 patients.
Pubmed, Web of Science, Embase, CNKI, VIP, Wanfang, Cochrane Library databases, medRxiv, and Sinomed were reviewed systemically. Various types of clinical research reporting cardiac-related comorbidities, cardiac biomarkers including lactate dehydrogenase (LDH), troponin I (TnI), high sensitivity troponin I (hs-TnI), creatine kinase (CK), creatine kinase-MB (CK-MB), myoglobin (Myo), N-terminal pro-b-type natriuretic peptide (NT-proBNP) and acute cardiac injury grouped by severity of COVID-19 were included. Outcome measures were events and total sample size for comorbidities, acute cardiac injury, and laboratory parameters of these biomarkers. The study was performed with Stata version 15.1.
Seventy studies, with a total of 15,354 cases were identified. The results showed that COVID-19\'s severity was related to cardiovascular disease. Similar odds ratios (ORs) were achieved in hypertension except for severe versus critical group (OR = 1.406; 95% CI, 0.942-2.097; p = .095). The relative risk (RR) of acute cardiac injury is 7.01 (95% CI, 5.64-8.71) in non-survivor cases. When compared with the different severity of cardiac biomarkers, the pool OR of CK, CK-MB, TnI, Myo and LDH were 2.683 (95% CI, 0.83-8.671; p = .106; I2 = 0%), 2.263 (95% CI, 0.939-5.457; p = .069), 1.242 (95% CI, 0.628-2.457; p = .534), 1.756 (95% CI, 0.608-5.071; p = .298; I2 = 42.3%), 1.387 (95% CI, 0.707-2.721; p = .341; I2 = 0%) in the critical versus severe group, whose trends were not similar to other groups. The standard mean differences (SMD) of CK and TnI in the critical versus severe group were 0.09 (95% CI, -0.33 to 0.50; p = .685; I2 = 65.2%), 0.478 (95% CI, -0.183 to 1.138; p = .156; I2 = 76.7%), which means no difference was observed in the serum level of these indicators.
Most of the findings clearly indicate that hypertension, cardiovascular disease, acute cardiac injury, and related laboratory indicators are associated with the severity of COVID-19. What is now needed are cross-national prospectively designed observational or clinical trials that will help improve the certainty of the available evidence and treatment decisions for patients.
Pubmed, Web of Science, Embase, CNKI, VIP, Wanfang, Cochrane Library databases, medRxiv, and Sinomed were reviewed systemically. Various types of clinical research reporting cardiac-related comorbidities, cardiac biomarkers including lactate dehydrogenase (LDH), troponin I (TnI), high sensitivity troponin I (hs-TnI), creatine kinase (CK), creatine kinase-MB (CK-MB), myoglobin (Myo), N-terminal pro-b-type natriuretic peptide (NT-proBNP) and acute cardiac injury grouped by severity of COVID-19 were included. Outcome measures were events and total sample size for comorbidities, acute cardiac injury, and laboratory parameters of these biomarkers. The study was performed with Stata version 15.1.
Seventy studies, with a total of 15,354 cases were identified. The results showed that COVID-19\'s severity was related to cardiovascular disease. Similar odds ratios (ORs) were achieved in hypertension except for severe versus critical group (OR = 1.406; 95% CI, 0.942-2.097; p = .095). The relative risk (RR) of acute cardiac injury is 7.01 (95% CI, 5.64-8.71) in non-survivor cases. When compared with the different severity of cardiac biomarkers, the pool OR of CK, CK-MB, TnI, Myo and LDH were 2.683 (95% CI, 0.83-8.671; p = .106; I2 = 0%), 2.263 (95% CI, 0.939-5.457; p = .069), 1.242 (95% CI, 0.628-2.457; p = .534), 1.756 (95% CI, 0.608-5.071; p = .298; I2 = 42.3%), 1.387 (95% CI, 0.707-2.721; p = .341; I2 = 0%) in the critical versus severe group, whose trends were not similar to other groups. The standard mean differences (SMD) of CK and TnI in the critical versus severe group were 0.09 (95% CI, -0.33 to 0.50; p = .685; I2 = 65.2%), 0.478 (95% CI, -0.183 to 1.138; p = .156; I2 = 76.7%), which means no difference was observed in the serum level of these indicators.
Most of the findings clearly indicate that hypertension, cardiovascular disease, acute cardiac injury, and related laboratory indicators are associated with the severity of COVID-19. What is now needed are cross-national prospectively designed observational or clinical trials that will help improve the certainty of the available evidence and treatment decisions for patients.
摘要：
探讨心脏相关合并症之间的相关性，心脏生物标志物，急性心肌损伤,和严重性级别，COVID-19患者的结局。
已发布，WebofScience,Embase,CNKI,VIP,万方,Cochrane图书馆数据库,medRxiv,和Sinomed进行了系统审查。各种类型的临床研究报告心脏相关的合并症，心脏生物标志物，包括乳酸脱氢酶（LDH），肌钙蛋白I(TnI),高灵敏度肌钙蛋白I（hs-TnI），肌酸激酶（CK），肌酸激酶-MB（CK-MB），肌红蛋白(Myo),包括N末端B型利钠肽前体（NT-proBNP）和按COVID-19严重程度分组的急性心脏损伤。结果衡量标准是合并症的事件和总样本量，急性心脏损伤,和这些生物标志物的实验室参数。该研究使用Stata版本15.1进行。
七十项研究,共发现15354例。结果显示COVID-19的严重程度与心血管疾病有关。除重度和危重组外，高血压的比值比（OR）相似（OR=1.406；95％CI，0.942-2.097；p=0.095）。在非存活病例中，急性心脏损伤的相对风险（RR）为7.01（95％CI，5.64-8.71）。与不同严重程度的心脏生物标志物相比，游泳池或CK，CK-MB,TnI,Myo和LDH为2.683（95％CI，0.83-8.671；p=.106；I2=0％），2.263（95%CI，0.939-5.457；p=0.069），1.242（95%CI，0.628-2.457；p=.534），1.756（95%CI，0.608-5.071；p=.298；I2=42.3%），1.387（95％CI，0.707-2.721；p=.341；I2=0％）在严重组与严重组，其趋势与其他组不同。危重组与重度组的CK和TnI的标准平均差异（SMD）为0.09（95％CI，-0.33至0.50；p=.685；I2=65.2％），0.478（95%CI，-0.183至1.138；p=.156；I2=76.7%），这意味着这些指标的血清水平没有差异。
大多数研究结果清楚地表明，高血压，心血管疾病,急性心脏损伤,相关实验室指标与COVID-19的严重程度相关。现在需要的是跨国前瞻性设计的观察或临床试验，这将有助于提高患者可用证据和治疗决策的确定性。
已发布，WebofScience,Embase,CNKI,VIP,万方,Cochrane图书馆数据库,medRxiv,和Sinomed进行了系统审查。各种类型的临床研究报告心脏相关的合并症，心脏生物标志物，包括乳酸脱氢酶（LDH），肌钙蛋白I(TnI),高灵敏度肌钙蛋白I（hs-TnI），肌酸激酶（CK），肌酸激酶-MB（CK-MB），肌红蛋白(Myo),包括N末端B型利钠肽前体（NT-proBNP）和按COVID-19严重程度分组的急性心脏损伤。结果衡量标准是合并症的事件和总样本量，急性心脏损伤,和这些生物标志物的实验室参数。该研究使用Stata版本15.1进行。
七十项研究,共发现15354例。结果显示COVID-19的严重程度与心血管疾病有关。除重度和危重组外，高血压的比值比（OR）相似（OR=1.406；95％CI，0.942-2.097；p=0.095）。在非存活病例中，急性心脏损伤的相对风险（RR）为7.01（95％CI，5.64-8.71）。与不同严重程度的心脏生物标志物相比，游泳池或CK，CK-MB,TnI,Myo和LDH为2.683（95％CI，0.83-8.671；p=.106；I2=0％），2.263（95%CI，0.939-5.457；p=0.069），1.242（95%CI，0.628-2.457；p=.534），1.756（95%CI，0.608-5.071；p=.298；I2=42.3%），1.387（95％CI，0.707-2.721；p=.341；I2=0％）在严重组与严重组，其趋势与其他组不同。危重组与重度组的CK和TnI的标准平均差异（SMD）为0.09（95％CI，-0.33至0.50；p=.685；I2=65.2％），0.478（95%CI，-0.183至1.138；p=.156；I2=76.7%），这意味着这些指标的血清水平没有差异。
大多数研究结果清楚地表明，高血压，心血管疾病,急性心脏损伤,相关实验室指标与COVID-19的严重程度相关。现在需要的是跨国前瞻性设计的观察或临床试验，这将有助于提高患者可用证据和治疗决策的确定性。
