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COVID-19 Outcomes Amongst Patients With Pre-existing Cardiovascular Disease and Hypertension

Raja Chandra Chakinala1,2, Chail D Shah3, Jigisha H Rakholiya4

  • 1Medicine, Geisinger Commonwealth School of Medicine, Danville, USA.

Cureus
|March 25, 2021
PubMed

Insights

Cardiovascular disease (CVD) and hypertension (HTN) increase the risk of poor outcomes in COVID-19 patients. While CVD is linked to mechanical ventilation, neither condition independently raises mortality risk.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Public Health

Background:

  • Coronavirus disease 2019 (COVID-19) can cause severe illness, particularly in individuals with pre-existing cardiovascular disease (CVD) and hypertension (HTN).
  • Understanding the impact of these comorbidities on COVID-19 outcomes is crucial for patient management and public health strategies.

Purpose of the Study:

  • To conduct a meta-analysis and meta-regression evaluating the outcomes of COVID-19 patients with pre-existing cardiovascular disease (CVD) and hypertension (HTN).
  • To assess the association between CVD, HTN, and outcomes such as mortality and invasive mechanical ventilation (IMV) utilization.

Main Methods:

  • A systematic literature search was performed on PubMed for observational studies published from December 2019 to July 2020.
  • Studies reporting epidemiological data, CVD, HTN, mortality, and IMV utilization in COVID-19 patients were selected.
  • Random-effects models were used for meta-analysis and meta-regression to estimate pooled prevalence, odds ratios (OR), and correlation coefficients (r).

Main Results:

  • The meta-analysis included 29 studies with 27,950 COVID-19 patients. Pooled prevalence of CVD was 18.2% and HTN was 32.7%.
  • Both CVD (OR: 3.36) and HTN (OR: 1.94) were associated with a composite poor outcome in COVID-19 patients.
  • Age-adjusted meta-regression revealed CVD was significantly correlated with higher IMV utilization (r: 0.28; OR: 1.3), but not mortality (r: -0.01). HTN showed no significant correlation with IMV utilization or mortality.

Conclusions:

  • Pre-existing cardiovascular disease (CVD) is a significant risk factor for increased invasive mechanical ventilation (IMV) utilization in COVID-19 patients.
  • Neither pre-existing cardiovascular disease (CVD) nor hypertension (HTN) demonstrated an independent association with increased mortality in COVID-19 patients.
  • These findings highlight the differential impact of comorbidities on specific COVID-19 outcomes, emphasizing the need for tailored clinical management.
Abstract

Keywords:
2019-ncovatrial fibrillationcardiovascular diseasecoronavirus disease 2019 (covid-19)hypertensioninvasive mechanical ventilationnovel coronavirus disease 2019risk factorssars-cov-2systematic review and meta-analysis

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