Worldwide impact of COVID-19 on hospital admissions for non-ST-elevation acute coronary syndromes (NSTACS): a systematic review with meta-analysis of 553 038 cases.

IF 4.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

European Heart Journal - Quality of Care and Clinical Outcomes Pub Date : 2024-05-22 DOI:10.1093/ehjqcco/qcad048

Francesco Sofi, Monica Dinu, GianPaolo Reboldi, Sofia Lotti, Luca Genovese, Isabella Tritto, GianFranco Gensini, Charles Michael Gibson, Giuseppe Ambrosio

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引用次数: 0

Abstract

Background: How coronavirus disease 2019 (COVID-19) impacted non-ST-segment elevation acute coronary syndromes (NSTACS) is an object of controversial reports.

Aim: To systematically review studies reporting NSTACS hospitalizations during the COVID-19 pandemic, and analyse whether differences in COVID-19 epidemiology, methodology of report, or public health-related factors could contribute to discrepant findings.

Methods: Comprehensive search (Medline, Embase, Scopus, Web of Science, Cochrane Register), of studies reporting NSTACS hospitalizations during the COVID-19 pandemic compared with a reference period, following Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Data were independently extracted by multiple investigators and pooled using a random-effects model. Health-related metrics were from publicly available sources, and analysed through multiple meta-regression modelling.

Results: We retrieved 102 articles (553 038 NSTACS cases, 40 countries). During peak COVID-19 pandemic, overall incidence rate ratio (IRR) of NSTACS hospitalizations over reference period decreased (0.70, 95% confidence interval (CI) 0.66-0.75; P < 0.00001). Significant heterogeneity was detected among studies (I2 = 98%; P < 0.00001). Importantly, wide variations were observed among, and within, countries. No significant differences were observed by study quality, whereas comparing different periods within 2020 resulted in greater decrease (IRR: 0.61; CI: 0.53-0.71) than comparing 2020 vs. previous years (IRR: 0.74; CI 0.69-0.79). Among many variables, major predictors of heterogeneity were severe acute respiratory syndrome coronavirus 2 reproduction rate/country, number of hospitals queried, and reference period length; country stringency index and socio-economical indicators did not contribute significantly.

Conclusions: During the COVID-19 pandemic, NSTACS hospitalizations decreased significantly worldwide. However, substantial heterogeneity emerged among countries, and within the same country. Factors linked to public health management, but also to methodologies to collect results may have contributed to this heterogeneity.

Trial registration: The protocol was registered in the PROSPERO International Prospective Register of Systematic Reviews (ID: CRD42022308159).

查看原文本刊更多论文

COVID-19对全球非st段抬高急性冠状动脉综合征(NSTACS)住院率的影响:一项包含553,038例病例的荟萃分析的系统综述

背景:COVID-19如何影响非st段抬高急性冠状动脉综合征(NSTACS)是有争议的报道对象。目的:系统回顾报告COVID-19大流行期间NSTACS住院的研究，并分析COVID-19流行病学、报告方法或公共卫生相关因素的差异是否可能导致差异结果。方法:综合检索(MedLine, Embase, Scopus, Web-of-Science, Cochrane Register)，根据系统评价和荟萃分析(PRISMA)指南的首选报告项目，将报告COVID-19大流行期间NSTACS住院的研究与参考期进行比较。数据由多个研究者独立提取，并使用随机效应模型汇总。健康相关指标来自公开来源，并通过多元元回归模型进行分析。结果:我们检索到102篇文献(553 038例NSTACS病例，来自40个国家)。在COVID-19大流行高峰期间，NSTACS住院总发病率比(IRR)在参考期内下降(0.70,95% CI 0.66-0.75;p结论:在COVID-19大流行期间，全球NSTACS住院人数显著减少。然而，各国之间和同一国家内部出现了很大的差异。与公共卫生管理有关的因素以及收集结果的方法可能造成这种异质性。试验注册:该方案已在普洛斯彼罗国际前瞻性系统评价注册(ID: CRD42022308159)中注册。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Heart Journal - Quality of Care and Clinical Outcomes CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

9.40

自引率

3.80%

发文量

期刊介绍： European Heart Journal - Quality of Care & Clinical Outcomes is an English language, peer-reviewed journal dedicated to publishing cardiovascular outcomes research. It serves as an official journal of the European Society of Cardiology and maintains a close alliance with the European Heart Health Institute. The journal disseminates original research and topical reviews contributed by health scientists globally, with a focus on the quality of care and its impact on cardiovascular outcomes at the hospital, national, and international levels. It provides a platform for presenting the most outstanding cardiovascular outcomes research to influence cardiovascular public health policy on a global scale. Additionally, the journal aims to motivate young investigators and foster the growth of the outcomes research community.