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Cardiovascular diseases burden in COVID-19: Systematic review and meta-analysis
Amirhossein Hessami1, Amir Shamshirian2, Keyvan Heydari3
1Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Insights
COVID-19 patients face a high burden of cardiovascular diseases (CVDs), significantly increasing mortality and ICU admission risks. Early detection and management of cardiac conditions in COVID-19 patients are crucial for better outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Novel coronavirus disease (COVID-19) is associated with a high incidence of cardiovascular disease (CVD).
- Previous studies have shown conflicting results regarding the burden of CVD in COVID-19 patients.
- This study addresses the need for a comprehensive analysis of CVD burden in COVID-19 patients.
Purpose of the Study:
- To systematically review and meta-analyze the burden of cardiovascular diseases (CVDs) in patients with COVID-19.
- To investigate the association between various CVDs and outcomes such as mortality and Intensive Care Unit (ICU) admission in COVID-19 patients.
Main Methods:
- A systematic search was conducted across major databases (PubMed, Embase, Cochrane Library, Scopus, Web of Science) and pre-print servers (medRxiv).
- Meta-analyses were performed to calculate Odds Ratios (OR) for mortality and ICU admission associated with different CVDs.
- Descriptive meta-analysis was also employed to summarize the prevalence of various CVDs.
Main Results:
- The analysis included 56 studies for mortality/ICU outcomes and 198 for descriptive outcomes, encompassing 159,698 COVID-19 patients.
- Significant associations were found between several CVDs (acute cardiac injury, hypertension, heart failure, arrhythmia, coronary artery disease) and increased mortality.
- Similarly, conditions like arrhythmia, acute cardiac injury, coronary heart disease, cardiovascular disease, and hypertension were significantly linked to ICU admission.
Conclusions:
- COVID-19 patients exhibit a substantial burden of cardiovascular diseases, strongly correlated with higher mortality and ICU admission rates.
- Proactive management of CVD in COVID-19 patients and vigilant monitoring for acute cardiac complications are essential.
- These measures are recommended to mitigate mortality and prevent critical illness in this patient population.
Background:
High rate of cardiovascular disease (CVD) have been reported among patients with novel coronavirus disease (COVID-19). Meanwhile there were controversies among different studies about CVD burden in COVID-19 patients. Hence, we aimed to study CVD burden among COVID-19 patients, using a systematic review and meta-analysis.
Methods:
We have systematically searched databases including PubMed, Embase, Cochrane Library, Scopus, Web of Science as well as medRxiv pre-print database. Hand searched was also conducted in journal websites and Google Scholar. Meta-analyses were carried out for Odds Ratio (OR) of mortality and Intensive Care Unit (ICU) admission for different CVDs. We have also performed a descriptive meta-analysis on different CVDs.
Results:
Fifty-six studies entered into meta-analysis for ICU admission and mortality outcome and 198 papers for descriptive outcomes, including 159,698 COVID-19 patients. Results of meta-analysis indicated that acute cardiac injury, (OR: 13.29, 95% CI 7.35-24.03), hypertension (OR: 2.60, 95% CI 2.11-3.19), heart Failure (OR: 6.72, 95% CI 3.34-13.52), arrhythmia (OR: 2.75, 95% CI 1.43-5.25), coronary artery disease (OR: 3.78, 95% CI 2.42-5.90), and cardiovascular disease (OR: 2.61, 95% CI 1.89-3.62) were significantly associated with mortality. Arrhythmia (OR: 7.03, 95% CI 2.79-17.69), acute cardiac injury (OR: 15.58, 95% CI 5.15-47.12), coronary heart disease (OR: 2.61, 95% CI 1.09-6.26), cardiovascular disease (OR: 3.11, 95% CI 1.59-6.09), and hypertension (OR: 1.95, 95% CI 1.41-2.68) were also significantly associated with ICU admission in COVID-19 patients.
Conclusion:
Findings of this study revealed a high burden of CVDs among COVID-19 patients, which was significantly associated with mortality and ICU admission. Proper management of CVD patients with COVID-19 and monitoring COVID-19 patients for acute cardiac conditions is highly recommended to prevent mortality and critical situations.
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