Association Of Myocardial Injury With The Severity And Mortality Of Patients Infected With Novel Coronavirus Disease 2019(COVID-19): A Meta-analysis

Objective:As one of the major diseases affecting human health in recent years,novel coronavirus pneumonia has been considered to cause myocardial damage to patients infected with novel coronavirus to varying degrees.As a common complication of novel coronavirus infection,myocardial injury is also considered to be closely related to the mortality and clinical severity of patients with novel coronavirus infection.The purpose of this article is to conduct a meta-analysis of the existing documents that meet certain standards,to explore the potential relationship between myocardial injury and the severity and mortality of COVID-19,and to provide some guidance for the treatment of patients.Methods:The published Chinese and English literatures on the relationship between myocardial injury and death or severe disease of COVID-19 patients were searched in CNKI,Wanfang database,Vip Chinese scientific and technological journal database,PubMed and other databases,and the literatures were screened and extracted according to certain inclusion criteria.After the included literatures were evaluated according to the NOS literature quality evaluation scale,the statistical analysis software Stata17.0 was used for analysis.For the literature data with heterogeneity,sensitivity analysis,subgroup analysis and meta-regression are carried out to further explore the possible sources of heterogeneity and reduce the heterogeneity of the article,and to achieve the effect of merging homogeneous research.Results:The meta-analysis included 32 related articles,involving 19266 patients with novel coronavirus infection,with an average age of 54-71 years.From 6 countries and regions,28 were retrospective studies and 4 were prospective studies.There are 3 0 high-quality documents and 2 medium-quality documents.In this study,27 articles discussed the relationship between myocardial injury and death risk of patients with COVID-19,and concluded that compared with patients without myocardial injury,the death risk of patients with myocardial injury increased 7.64 times(95%CI=7.64(4.80,12.17),P<0.0001,I2=95.6%)。Another 19 articles discussed the relationship between myocardial injury and the severity of patients with COVID-19.The heterogeneity test was conducted on the 19 articles included,and the heterogeneity test found that(I 2=81.7%,P<0.001),there was heterogeneity,so the random effect model was used for combination.The combination of OR and 95%CI=6.32(4.63,8.63),that is,the risk of severe cases of COVID-19 patients with myocardial injury was 6.32 times higher than those without myocardial injury,and the combination was statistically significant(Z=11.61,P<0.001).Conclusion:There is a certain statistical relationship between myocardial injury and the mortality and severity of patients with novel coronavirus infection,that is,patients with myocardial injury can show a higher mortality and severe incidence rate clinically.Myocardial injury markers,echocardiography and endocardial biopsy can be used as indicators to predict the severity and mortality of COVID-19.For patients with myocardial damage,early detection and preventive treatment this morning will help improve the survival rate of patients with COVID-19,avoid clinical adverse consequences,and have certain guiding significance for clinical treatment.