Prevalence of cardiovascular symptoms in post-acute COVID-19 syndrome: a meta-analysis
Li-Wei Huang1, Hua-Min Li1, Bei He1
1Department of Pharmacy, the Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
Insights
COVID-19 infection significantly increases the risk of cardiovascular sequelae, including chest pain, palpitations, and hypertension. This meta-analysis highlights the importance of monitoring heart health post-infection.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- COVID-19 poses significant physical and mental health threats globally.
- Post-acute COVID-19 syndrome (PACS) may involve cardiovascular complications.
- Limited research exists on PACS cardiovascular manifestations, hindering treatment development.
Purpose of the Study:
- To investigate the prevalence of cardiovascular sequelae in COVID-19 patients.
- To determine if COVID-19 infection is an independent risk factor for cardiovascular outcomes.
Main Methods:
- Meta-analysis adhering to PRISMA guidelines, registered in PROSPERO (CRD42024524290).
- Systematic search of PubMed, Embase, and Cochrane Library up to March 17, 2024.
- Primary outcomes: hypertension, palpitations, chest pain. Pooled effect estimates reported as proportions and odds ratios (ORs) with 95% confidence intervals (CIs).
Main Results:
- Analysis of 37 studies with 2,965,467 patients.
- COVID-19 patients had higher odds of chest pain (OR=4.0), palpitations (OR=3.4), and hypertension (OR=1.7) compared to controls.
- Proportions of PACS patients with sequelae: chest pain (22%), palpitations (18%), hypertension (19%).
Conclusions:
- Approximately 15% of COVID-19 patients experience cardiovascular sequelae.
- COVID-19 infection significantly elevates the risk of developing these sequelae.
- Further research is needed on pathological mechanisms and targeted management strategies.
Background:
Since its emergence in 2019, COVID-19 has continued to pose significant threats to both the physical and mental health of the global population, as well as to healthcare systems worldwide (Raman et al., Eur Heart J 43:1157-1172, 2022). Emerging evidence indicates that COVID-19 may lead to post-acute COVID-19 syndrome (PACS) with cardiovascular implications, potentially driven by factors such as ACE2 interaction with viruses, systemic inflammation, and endothelial dysfunction. However, there remains a limited amount of research on the cardiovascular manifestations of PACS, which may delay the development of optimal treatment strategies for affected patients. Therefore, it is crucial to investigate the prevalence of cardiovascular sequelae in COVID-19 patients and to determine whether COVID-19 infection acts as an independent risk factor for these outcomes.
Methods:
This meta-analysis adhered to PRISMA guidelines and was registered in PROSPERO (CRD42024524290). A systematic search of PubMed, Embase, and the Cochrane Library was conducted up to March 17, 2024. The primary outcomes included hypertension, palpitations, and chest pain, with pooled effect estimate reported as proportions and odds ratios (ORs) with 95% confidence intervals (CIs). Sensitivity and subgroup analysis were performed to assess the robustness of the results and to identify sources of heterogeneity.
Results:
A total of 37 studies, encompassing 2,965,467 patients, were included in the analysis. Pooled results from case-control studies revealed that, compared to the control group, the ORs of chest pain in the COVID-19 group was 4.0 (95% CI: 1.6, 10.0). The ORs for palpitation and hypertension were 3.4 (95% CI: 1.1, 10.2) and 1.7 (95% CI: 1.6, 1.8), respectively. The proportions of PACS patients experiencing chest pain, palpitation, and hypertension as sequelae were 22% (95% CI: 14%, 33%), 18% (95% CI: 13%, 24%), and 19% (95% CI: 12%, 31%), respectively.
Conclusions:
Our findings indicate that 15% of COVID-19 patients experience cardiovascular sequelae. Furthermore, COVID-19 infection significantly increases the likelihood of developing these sequelae compared to uninfected individuals. Future research should prioritize investigating the underlying pathological mechanisms and developing targeted preventive and management strategies.
Trial Registration:
CRD42024524290.
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