Cardiac Injury and COVID-19: A Systematic Review and Meta-analysis
Fengwei Zou1, Zhiyong Qian2, Yao Wang2
1Georgetown University School of Medicine, Washington, District of Columbia, USA.
Insights
Acute cardiac injury is common in COVID-19 patients, significantly increasing mortality risk. Older patients with hypertension and COPD face higher risks, necessitating early cardiac monitoring.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- A link between COVID-19 infection and acute cardiac injury is observed.
- Consensus on incidence, prognosis, and cause of cardiac injury in COVID-19 is lacking.
- This study reviews incidence, comorbidities, outcomes, and mechanisms of cardiac injury in COVID-19.
Purpose of the Study:
- To conduct a comprehensive review and meta-analysis of acute cardiac injury in COVID-19 patients.
- To determine the incidence, comorbidities, and outcomes associated with cardiac injury in COVID-19.
- To explore possible mechanisms underlying cardiac injury in COVID-19.
Main Methods:
- Searched PubMed and Embase for relevant studies.
- Included studies evaluating cardiac injury in hospitalized COVID-19 patients.
- Performed meta-analysis on extracted demographic, comorbidity, and laboratory data.
Main Results:
- Included 16 studies with 2224 patients.
- Cardiac injury incidence was 24.4% in hospitalized COVID-19 patients.
- Mortality was significantly higher (72.6%) in patients with cardiac injury compared to those without (14.5%).
- Older age, hypertension, and COPD were associated with increased risk of cardiac injury.
Conclusions:
- Acute cardiac injury is prevalent in COVID-19 patients and strongly linked to mortality.
- Older patients with hypertension and COPD are more susceptible to cardiac injury.
- Recommends early screening, triage, and cardiac monitoring for high-risk COVID-19 patients.
Background:
During the current COVID-19 pandemic, a link between acute cardiac injury and COVID-19 infection has been observed. There is currently no consensus on the incidence of cardiac injury, its relationship to prognosis, or its possible cause. In this article we provide a comprehensive review and meta-analysis of the incidence, comorbidities, outcomes, and possible mechanisms of acute cardiac injury in COVID-19 patients.
Methods:
We searched PubMed and Embase for studies that evaluated cardiac injury in hospitalized COVID-19 patients. Data on demographic information, comorbidities, and relevant laboratory values were extracted and a meta-analysis was performed.
Results:
Sixteen studies from China, Italy, and the United States with 2224 patients were included in this meta-analysis. The incidence of cardiac injury was 24.4% (542/2224 patients) in hospitalized COVID-19 patients. The all-cause mortality in patients with cardiac injury was 72.6% (odds ratio, 17.32; 95% confidence interval, 9.21-32.57) compared with those without cardiac injury (14.5%). In subgroup analyses, factors associated with increased risk of developing cardiac injury were older age and history of hypertension, and chronic obstructive respiratory disease.
Conclusions:
Cardiac injury is common in hospitalized COVID-19 patients and is significantly associated with mortality. Patients who were older with hypertension and chronic obstructive respiratory disease were prone to develop cardiac injury. Early screening, triage, and cardiac monitoring are recommended for these patients.
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