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Comorbid Chronic Diseases and Acute Organ Injuries Are Strongly Correlated with Disease Severity and Mortality among COVID-19 Patients: A Systemic Review and Meta-Analysis

机译:合并症的慢性病和急性器官损伤与COVID-19患者的疾病严重程度和死亡率密切相关:系统评价和荟萃分析

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摘要

The recent outbreak of COVID-19 has been rapidly spreading on a global scale. To date, there is no specific vaccine against the causative virus, SARS-CoV-2, nor is there an effective medicine for treating COVID-19, thus raising concerns with respect to the effect of risk factors such as clinical course and pathophysiological parameters on disease severity and outcome in patients with COVID-19. By extracting and analyzing all available published clinical data, we identified several major clinical characteristics associated with increased disease severity and mortality among patients with COVID-19. Specifically, preexisting chronic conditions such as hypertension, cardiovascular disease, chronic kidney disease, and diabetes are strongly associated with an increased risk of developing severe COVID-19; surprisingly, however, we found no correlation between chronic liver disease and increased disease severity. In addition, we found that both acute cardiac injury and acute kidney injury are highly correlated with an increased risk of COVID-19-related mortality. Given the high risk of comorbidity and the high mortality rate associated with tissue damage, organ function should be monitored closely in patients diagnosed with COVID-19, and this approach should be included when establishing new guidelines for managing these high-risk patients. Moreover, additional clinical data are needed in order to determine whether a supportive therapy can help mitigate the development of severe, potentially fatal complications, and further studies are needed to identify the pathophysiology and the mechanism underlying this novel coronavirus-associated infectious disease. Taken together, these findings provide new insights regarding clinical strategies for improving the management and outcome of patients with COVID-19.
机译:最近爆​​发的COVID-19已在全球范围内迅速传播。迄今为止,还没有针对致病性病毒SARS-CoV-2的特异性疫苗,也没有有效的药物可治疗COVID-19,因此引起了对诸如临床病程和病理生理参数等危险因素影响的担忧。 COVID-19患者的疾病严重程度和预后。通过提取和分析所有可用的已发表临床数据,我们确定了COVID-19患者中与疾病严重性和死亡率增加相关的几个主要临床特征。特别是,高血压,心血管疾病,慢性肾脏疾病和糖尿病等已存在的慢性疾病与患严重COVID-19的风险增加密切相关。然而,令人惊讶的是,我们发现慢性肝病与疾病严重程度之间没有相关性。此外,我们发现急性心脏损伤和急性肾损伤均与COVID-19相关死亡率增加的风险高度相关。鉴于合并症的高风险和与组织损伤相关的高死亡率,应在诊断为COVID-19的患者中严密监测器官功能,在建立新的指南以管理这些高危患者时应包括这种方法。此外,还需要其他临床数据来确定支持疗法是否可以帮助减轻严重的,可能致命的并发症的发展,还需要进一步的研究以鉴定这种新型冠状病毒相关感染性疾病的病理生理学和机制。综上所述,这些发现为改善COVID-19患者的治疗和结局的临床策略提供了新见解。

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