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Cardiac Complications in COVID-19: A Systematic Review and Meta-analysis

Mehrdad Sahranavard1, Arash Akhavan Rezayat2,3, Mohammad Zamiri Bidary3

  • 1Student Research Committee, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.

Archives of Iranian Medicine
|February 27, 2021
PubMed

Insights

COVID-19 frequently impacts the heart, with significant rates of myocardial injury and heart failure. Elevated cardiac troponin I (cTnI) levels were notably higher in non-surviving patients, indicating severe cardiac involvement.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • The COVID-19 pandemic has revealed multi-organ involvement, including the cardiovascular system.
  • Understanding cardiac complications is crucial for managing COVID-19 patients.
  • Systematic review and meta-analysis are essential for synthesizing evidence on COVID-19's cardiac effects.

Purpose of the Study:

  • To systematically review and calculate the pooled incidences of cardiac complications in COVID-19 patients.
  • To compare cardiac troponin I (cTnI) levels between surviving and non-surviving COVID-19 patients.

Main Methods:

  • A systematic literature search was performed for studies published between December 2019 and April 2020.
  • Data on cardiovascular complications and cardiac biomarkers (cTnI, CK, CK-MB) were extracted from hospitalized, PCR-confirmed COVID-19 cases.
  • Pooled incidences were calculated, and cTnI levels were compared between survivors and non-survivors.

Main Results:

  • The pooled incidence of arrhythmia was 10.11%, myocardial injury was 17.85%, and heart failure was 22.34%.
  • Pooled incidence rates for elevated cTnI, CK-MB, and CK were 15.16%, 10.92%, and 12.99%, respectively.
  • Non-survivors exhibited significantly higher pooled cTnI levels compared to survivors (mean difference = 31.818, P < 0.001).

Conclusions:

  • COVID-19 significantly affects the cardiovascular system, with the myocardium being particularly vulnerable.
  • Elevated cTnI levels are a strong indicator of disease severity and mortality in COVID-19 patients.
  • These findings highlight the importance of cardiac monitoring in COVID-19 management.
Abstract

Keywords:
COVID-19Cardiac complicationsCreatine kinase MB formMyocardial injury

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