COVID-19 对急性肢体缺血患者截肢率和死亡率的影响:系统回顾与元分析》。

Diseases Pub Date : 2024-04-07 DOI:10.3390/diseases12040074
Lelio Crupi, Alessio Ardizzone, Fabrizio Calapai, S. Scuderi, Filippo Benedetto, Emanuela Esposito, A. Capra
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引用次数: 0

摘要

自 SARS-CoV-2 大流行以来,世界各地的医疗系统发现 COVID-19 感染者的急性肢体缺血(ALI)发生率有所上升。尽管有多项证据表明,COVID-19 感染也可能使 ALI 的预后恶化,但只有少数已发表的研究对 COVID-19 和非 COVID-19 ALI 患者的预后进行了直接比较。根据上述情况,我们对文献进行了系统性回顾和荟萃分析,评估了同时受 COVID-19 影响的患者与阴性 ALI 受试者之间两种主要结局(截肢和死亡率)发生率的差异。从 2020 年 1 月至 2023 年 12 月 31 日,对 PubMed(MEDLINE)、Web of Science 和 Embase(OVID)数据库进行了仔细研究,共检索到 7906 篇文章。共有 11 项研究(n:15803 名受试者)被纳入系统综述,其中 10 项研究(15305 名患者)被纳入荟萃分析。在所有研究中,COVID-19 阳性 ALI 患者的预后较差(死亡率从 6.7% 到 47.2%;截肢率从 7.0% 到 39.1%),而非感染性 ALI 患者的预后较好(死亡率从 3.1% 到 16.7%;截肢率从 2.7% 到 18%)。同样,我们的荟萃分析表明,与 ALI 患者相比,COVID-19 ALI 患者的截肢率(OR:2.31;95% CI:1.68-3.17;p < 0.00001)和死亡率(OR:3.64;95% CI:3.02-4.39;p < 0.00001)都明显较高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Impact of COVID-19 on Amputation and Mortality Rates in Patients with Acute Limb Ischemia: A Systematic Review and Meta-Analysis.
Since the inception of the SARS-CoV-2 pandemic, healthcare systems around the world observed an increased rate of Acute Limb Ischemia (ALI) in patients with a COVID-19 infection. Despite several pieces of evidence suggesting that COVID-19 infection may also worsen the prognosis associated with ALI, only a small number of published studies include a direct comparison regarding the outcomes of both COVID-19 and non-COVID-19 ALI patients. Based on the above, a systematic review and a meta-analysis of the literature were conducted, evaluating differences in the incidence of two major outcomes (amputation and mortality rate) between patients concurrently affected by COVID-19 and negative ALI subjects. PubMed (MEDLINE), Web of Science, and Embase (OVID) databases were scrutinized from January 2020 up to 31 December 2023, and 7906 total articles were recovered. In total, 11 studies (n: 15,803 subjects) were included in the systematic review, and 10 of them (15,305 patients) were also included in the meta-analysis. Across all the studies, COVID-19-positive ALI patients experienced worse outcomes (mortality rates ranging from 6.7% to 47.2%; amputation rates ranging from 7.0% to 39.1%) compared to non-infected ALI patients (mortality rates ranging from 3.1% to 16.7%; amputation rates ranging from 2.7% to 18%). Similarly, our meta-analysis shows that both the amputation rate (OR: 2.31; 95% CI: 1.68-3.17; p < 0.00001) and mortality (OR: 3.64; 95% CI: 3.02-4.39; p < 0.00001) is significantly higher in COVID-19 ALI patients compared to ALI patients.
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