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Updated: Jul 17, 2025
Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
A network meta-analysis of association between cardiometabolic risk factors and COVID-19 outcome severity
Alina Binbin Li1, Bo Yang1, Yufei Li1
1Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA.
Insights
Cardiometabolic risk factors increase COVID-19 severity. Stroke and heart failure pose the highest mortality and severity risks, respectively. Combined cardiovascular disease and diabetes are most detrimental.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Cardiometabolic comorbidities are linked to increased COVID-19 severity and mortality.
- Further research is needed to identify the most detrimental cardiometabolic risk factors for COVID-19 outcomes.
Purpose of the Study:
- To systematically assess the associations between various cardiometabolic risk factors and COVID-19 outcomes.
- To identify which specific cardiometabolic conditions pose the greatest risk for hospitalization, severity, and mortality in COVID-19 patients.
Main Methods:
- Systematic literature search of Embase, Emcare, and MEDLINE for studies published up to May 19, 2021.
- Inclusion of prospective and retrospective studies evaluating cardiometabolic risk factors and COVID-19 outcomes.
- Quality assessment of included studies using the Newcastle-Ottawa Scale.
Main Results:
- All investigated cardiometabolic risk factors, except overweight, were associated with increased COVID-19 hospitalization, severity, and mortality.
- Diabetes showed the highest risk for hospitalization (RR 1.46), heart failure for severe outcomes (RR 1.89), and stroke for mortality (RR 1.99).
- Cerebrovascular disease had the highest impact in network meta-analysis (RR 1.69); combined cardiovascular disease and diabetes were most detrimental (RR 6.98).
Conclusions:
- Cardiometabolic comorbidities significantly increase the risk of severe COVID-19 outcomes.
- Patients with cardiometabolic conditions require prioritization for COVID-19 vaccination and treatment strategies.
- Identifying and managing these risk factors is crucial for mitigating COVID-19's impact.
Background:
Cardiometabolic comorbidities have been associated with a higher risk of COVID-19 severity and mortality, but more investigations are needed to determine which comorbidity is more detrimental.
Methods:
Embase, Emcare, and MEDLINE were searched systematically for prospective and retrospective studies assessing the associations of cardiometabolic risk factors and COVID-19 outcomes of hospitalization, severity, and mortality among COVID-19-diagnosed patients. Literature search was performed from first publication to May 19, 2021. Study quality was assessed by the Newcastle-Ottawa Scale.
Results:
From the literature search, 301 studies suggested that all included cardiometabolic risk factors were associated with a higher risk of COVID-19 hospitalization, severity, and mortality, except that overweight was associated with a decreased risk of mortality (relative risk [RR] 0.88; 95% CI, 0.80-0.98). Patients with diabetes (RR 1.46; 95% CI, 1.45-1.47) were most likely to be hospitalized; patients with heart failure had the highest risk for severe COVID-19 outcomes (RR 1.89; 95% CI, 1.71-2.09); while patients with stroke were most susceptible to overall mortality (RR 1.99; 95% CI, 1.90-2.08). In the network meta-analysis, cerebrovascular disease had the highest impact (RR 1.69; 95% CI, 1.65-1.73) on COVID-19 outcomes compared to other cardiometabolic risk factors. For different combinations of risk factors, cardiovascular disease and diabetes combined (RR 6.98; 95% CI, 5.28-9.22) was more detrimental than others.
Conclusions:
Considering the high prevalence of cardiometabolic comorbidities and risk of all severe outcomes, patients with cardiometabolic comorbidities should be prioritized in vaccination and treatment development of COVID-19.
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