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Published on: July 12, 2024
Heart failure as a complication of COVID-19 infection: systematic review and meta-analysis
Marco Zuin1, Gianluca Rigatelli2, Claudio Bilato3
1Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
Insights
Acute heart failure (HF) is a common complication of COVID-19, significantly increasing short-term mortality risk. This systematic review highlights the prevalence and prognostic implications of HF in COVID-19 patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- The prevalence and prognostic implications of heart failure (HF) as a complication of COVID-19 remain unclear.
- Understanding these factors is crucial for managing COVID-19 patients.
Purpose of the Study:
- To evaluate the pooled incidence of acute HF in COVID-19 patients.
- To estimate the mortality risk associated with acute HF in this population.
Main Methods:
- Systematic review and meta-analysis of studies published up to December 2020.
- Inclusion of 1064 patients from six investigations.
- Application of fixed-effects or random-effects models based on statistical heterogeneity.
Main Results:
- Pooled incidence of acute HF in COVID-19 patients was 20.2% (95% CI: 11.1-33.9%).
- A significant increased risk of death was observed in COVID-19 patients with acute HF (OR 9.36, 95% CI 4.76-18.4).
- Age did not show a statistically significant relationship with HF incidence or mortality risk.
Conclusions:
- Acute HF is a frequent complication of COVID-19 infection.
- COVID-19 patients with acute HF face a higher short-term mortality risk.
Background/Objectives:
The prevalence and prognostic implications of heart failure (HF), as a complication of COVID-19 infection remains unclear. We performed a systematic review and metanalysis aimed to evaluate the pooled incidence of acute HF as a cardiac complication of COVID-19 disease and to estimate the related mortality risk in these patients.
Methods:
Data were obtained searching MEDLINE, Scopus and Web of Science for all investigations published any time to 26 December 2020. If statistical heterogeneity was 50%, the results were derived from the fixed-effects model otherwise the random-effects model.
Results:
Overall, 1064 patients [mean age 66 years, 618 males] were included in the final analysis reviewing six investigations. The cumulative in-hospital rate of COVID-19 patients complicated by acute HF ranged between 6.9 and 63.4% among the studies reviewed. A random effect model revealed a pooled incidence of COVID-19 patients complicated by acute HF in 20.2% of cases (95% CI: 11.1-33.9%, p < 0.0001 I2 = 94.4%). A second pooled analysis, based on a random-effect model, confirmed a significant increased risk of death in COVID-19 patients complicated by acute HF during the infection (OR 9.36, 95% CI 4.76-18.4, p < 0.0001, I2 = 56.6%). Meta-regression analysis, using age as moderator variable, failed in founding a statistically significant relationship with the incidence of acute HF onset as a complication of COVID-19 disease (p = 0.062) or the mortality risk among the same subjects (p = 0.053).
Conclusions:
Acute HF represents a frequent complication of COVID-19 infection associated with a higher risk of mortality in the short-term period.
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