Prävalenz und prognostische Rolle der thorakalen Lymphadenopathie bei Covid-19

Zusammenfassung

Ziel Die Coronavirus-Pandemie 2019 (COVID-19) hat sich weltweit ausgebreitet und stellt nach wie vor eine ernste Bedrohung für die globale Gesundheit dar. Die prognostische Rolle der thorakalen Lymphadenopathie bei Covid-19 ist unklar. Ziel der vorliegenden systematischen Übersichtsarbeit und Meta-Analyse war es, die prognostische Rolle der thorakalen Lymphadenopathie für die Vorhersage der hospitalen Mortalität bei Patienten mit COVID-19 zu analysieren.

Materialien und Methoden Die Datenbanken MEDLINE, Cochrane und SCOPUS wurden nach thorakaler Lymphadenopathie und der intrahospitalen Mortalität bei COVID-19-Patienten bis Juni 2023 durchsucht. Insgesamt waren 21 Studien für die Analyse geeignet und wurden in die vorliegende Studie aufgenommen. Die Qualität der eingeschlossenen Studien wurde anhand der Newcastle-Ottawa-Skala eingeschätzt. Die Meta-Analyse wurde mit RevMan 5.3 durchgeführt. Die Heterogenität wurde mit dem Inkonsistenzindex (I²) berechnet. DerSimonian und Laird Random-Effects-Modelle mit inversen Varianzgewichtungen wurden ohne weitere Korrekturen durchgeführt.

Ergebnisse Die eingeschlossenen Studien umfassten 4621 Patienten. Die Prävalenz der mediastinalen Lymphadenopathie variierte in den Studien zwischen 1 % und 73,4 %. Die gepoolte Prävalenz betrug 16,7 % mit 95 % CI = (15,6 %; 17,8 %). Die hospitale Mortalität war bei Patienten mit mediastinaler Lymphadenopathie höher (34,7 %) als bei Patienten ohne mediastinale Lymphadenopathie (20,0 %). Die gepoolte Odds Ratio für den Einfluss der mediastinalen Lymphadenopathie auf die Mortalität betrug 2,13 (95 % CI = [1,80–2,52]; p < 0,001).

Schlussfolgerung Thorakale Lymphadenopathie tritt in 16,7 % bei Patienten mit COVID-19 auf. Bei COVID-19 ist das Vorhandensein einer thorakalen Lymphadenopathie mit einem etwa zweifach erhöhten Risiko der Krankenhausmortalität verbunden.

Kernaussagen 

• Die Prävalenz der COVID-19-Lymphadenopathie beträgt 16,7 %.

• Patienten mit COVID-19-Lymphadenopathie haben ein erhöhtes Krankenhausmortalitätsrisiko.

• Bei Lymphadenopathie besteht eine nahezu verdoppelte Mortalitätsrate.

Zitierweise

• Bucher AM, Sieren M, Meinel F et al. Prevalence and prognostic role of thoracic lymphadenopathy in Covid-19. Rofo 2025; 197: 163 – 171

Keywords

mediastinum - thorax - CT - infection - COVID-19 - meta-analysis

Publication History

Received: 04 January 2024

Accepted: 15 March 2024

Article published online:
22 July 2024

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