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A bidirectional Mendelian randomization analysis between COVID-19 and cardiac arrest

Xisha Tang1,2, Huijia Zhuang1,2, Hai Yu1

  • 1Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.

International Journal of Environmental Health Research
|June 12, 2024
PubMed

Insights

This study found no causal link between COVID-19 and cardiac arrest risk. Observational associations may be due to shared factors, not direct causation.

Area of Science:

  • Cardiovascular Epidemiology
  • Infectious Disease Epidemiology
  • Genetic Epidemiology

Background:

  • Observational studies suggest a link between COVID-19 and cardiac arrest (CA).
  • Causality is uncertain due to potential confounding factors in existing research.
  • Mendelian randomization (MR) offers a method to investigate genetic causality.

Purpose of the Study:

  • To investigate the causal relationship between COVID-19 and cardiac arrest (CA) using a two-sample Mendelian randomization (MR) approach.
  • To assess if COVID-19 causally increases the risk of CA.
  • To examine the potential reverse causality: if CA causally influences COVID-19 risk.

Main Methods:

  • Utilized genome-wide association study (GWAS) data for COVID-19 and CA.
  • Employed single nucleotide polymorphisms (SNPs) associated with COVID-19 and CA as instrumental variables.
  • Performed inverse-variance weighted (IVW) MR analysis and sensitivity analyses to address pleiotropy.
  • Conducted a reverse MR analysis to test causality from CA to COVID-19.

Main Results:

  • No significant causal effect was found for infected COVID-19 (OR=1.12, p=0.79), hospitalized COVID-19 (OR=1.02, p=0.920), or severe respiratory COVID-19 (OR=0.99, p=0.945) on CA risk.
  • Reverse MR analysis did not support a causal effect of CA on COVID-19.
  • Sensitivity analyses confirmed the robustness of these findings.

Conclusions:

  • The study provides no evidence for a causal link between COVID-19 and cardiac arrest.
  • Observed associations in epidemiological studies may be attributed to shared biological pathways or environmental confounders.
  • MR analysis strengthens the understanding of COVID-19's cardiovascular implications.

Keywords:
Coronavirus disease 2019 (COVID-19)Mendelian randomization (MR)cardiac arrest (CA)causal relationshipsingle nucleotide polymorphisms (SNPs)

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