TY - JOUR AU - Muthuka, John AU - Kiptoo, Michael AU - Oluoch, Kelly AU - Nzioki, Japheth Mativo AU - Nyamai, Everlyn Musangi PY - 2022 DA - 2022/10/4 TI -怀孕与冠状病毒细胞因子风暴的关联:系统回顾和荟萃分析乔- JMIR Pediatr父SP - e31579六世- 5 - 4 KW - COVID-19 KW -流行KW -怀孕KW -孕产妇健康KW -细胞因子KW -细胞激素风暴KW -免疫反应KW -传染病KW -冠状病毒KW -呼吸KW -病毒KW -怀孕AB -背景:COVID-19首次发现在武汉,中国,2019年12月,蔓延到世界的其余部分,成为流行。一些研究表明，怀孕状态和严重的COVID-19与细胞因子风暴之间存在关联，而另一些研究则显示出截然相反的结果。目的:本研究通过系统综述和meta分析，探讨妊娠状态与以细胞因子风暴为特征的临床COVID-19严重程度的关系。方法:我们检索了谷歌Scholar、PubMed、Scopus、Web of Science和Embase数据库，以确定适合纳入本荟萃分析的临床研究。纳入了报告妊娠状况和比较COVID-19严重程度细胞因子风暴结果的研究。采用以下参数描述以细胞因子风暴为特征的COVID-19严重程度:重症监护室入院、有创机械通气、机械通气、住院、促炎性和抗炎性细胞因子水平、胸部计算机断层扫描实变、肺部浸润、以细胞因子风暴为特征的极度发热、综合征严重程度、表明细胞因子风暴的较高中性粒细胞计数以及严重的COVID-19表现。结果:共纳入17篇文章，包括840,332名COVID-19女性的数据。该荟萃分析显示，阳性妊娠状态与严重COVID-19与细胞因子风暴之间存在相关性(随机效应模型优势比[OR] 2.47, 95% CI 1.63-3.73;P< 0.001)， COVID-19孕妇和非孕妇的累计发病率分别为6432例(14.1%)和24352例(3.1%)。 The fixed-effects model also showed a correlation between pregnancy status and severe COVID-19 with a cytokine storm (OR 7.41, 95% CI 7.02-7.83; P<.001). Considerable heterogeneity was found among all pooled studies (I²=98%, P<.001). Furthermore, the updated analysis showed substantially low heterogeneity (I²=29 %, P=.19), and the funnel plot revealed no publication bias. The subanalysis between single-center and multicenter studies demonstrated similar heterogeneity (I2=72% and 98%, respectively). Sensitivity analysis on each subgroup revealed that pregnancy was significantly related to severe COVID-19 with a cytokine storm from single-center studies (fixed-effects model OR 3.97, 95% CI 2.26-6.95; P<.001) with very low heterogeneity (I²=2%, P=.42). Conclusions: Being pregnant is clearly associated with experiencing a severe course of COVID-19 characterized by a cytokine storm. The COVID-19 pandemic should serve as an impetus for further research on pregnant women diagnosed with COVID-19 to map out the salient risk factors associated with its severity. Trial Registration: PROSPERO CRD42021242011; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=242011. SN - 2561-6722 UR - https://pediatrics.www.mybigtv.com/2022/4/e31579 UR - https://doi.org/10.2196/31579 UR - http://www.ncbi.nlm.nih.gov/pubmed/35319475 DO - 10.2196/31579 ID - info:doi/10.2196/31579 ER -