Mortality Assessment in Patients with Cardiovascular Disease and COVID-19: A Systematic Review and Meta-Analysis
Małgorzata Jarończyk1, Jarosław Walory2
1Paediatric Regional Centre for Digital Medicine, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
Insights
COVID-19 patients with cardiovascular disease (CVD) face triple the mortality risk. Additional conditions like diabetes, hypertension, and chronic kidney disease further increase death risk, especially CKD, which quadruples the danger.
Area of Science:
- Cardiology
- Infectious Diseases
- Nephrology
Background:
- The COVID-19 pandemic significantly impacted global health, particularly for individuals with pre-existing cardiovascular disease (CVD).
- Comorbidities such as diabetes (DM), hypertension (HT), and chronic kidney disease (CKD) are known to affect survival rates in infectious disease outbreaks.
- Understanding the interplay between COVID-19, CVD, and other chronic conditions is crucial for public health strategies.
Purpose of the Study:
- To determine the mortality rate in COVID-19 patients with cardiovascular disease.
- To assess the impact of common comorbidities (DM, HT, CKD) on mortality risk among COVID-19 patients.
Main Methods:
- A systematic review of studies published in PubMed, EMBASE, and Google Scholar (August 2020 - June 2025).
- Inclusion criteria focused on COVID-19 patients with CVD and associated comorbidities.
- Statistical analysis utilized a random-effects model with heterogeneity and publication bias assessments.
Main Results:
- Patients with CVD had significantly higher mortality rates (OR = 3.00).
- Comorbidities increased mortality risk: hypertension (OR = 1.94), diabetes mellitus (OR = 2.17).
- Chronic kidney disease presented the highest mortality risk (OR = 3.91), increasing the risk of death up to fourfold.
Conclusions:
- Cardiovascular disease is a major risk factor for mortality in COVID-19 patients.
- Diabetes, hypertension, and particularly chronic kidney disease, substantially elevate the risk of death in COVID-19 patients.
- These findings underscore the need for vigilant monitoring and tailored management of patients with CVD and comorbidities during pandemics.
Abstract:
The COVID-19 pandemic has had a profound impact on global health, especially among patients with cardiovascular disease (CVD) and the existence of additional conditions such as diabetes (DM), hypertension (HT), and chronic kidney disease (CKD) can have a significant impact on survival rates. The aim of this study was to determine the mortality rate in patients with CVD and the impact of other comorbidities on the death of patients with COVID-19. This systematic review was conducted using PubMed, EMBASE, and Google Scholar databases from August 2020 to June 2025. Inclusion criteria were patients with cardiovascular disease and associated comorbidities during the COVID-19 pandemic. Article selection was limited to articles published in English and Polish. Statistical analysis using a random-effects model was performed using STATA software. Heterogeneity between studies was examined, and a funnel plot for publication bias was generated. The higher mortality rates (OR = 3.00, 95% CI: 2.06-4.38) for patients with cardiovascular disease were observed. In the group of patients with comorbidities such as hypertension and diabetes mellitus the risk of death was also determined and for HT was OR = 1.94, 95% CI, 1.50-2.52 and for DM OR = 2.17, 95% CI: 1.64-2.86. The mortality in the chronic kidney disease group was higher than for HT and DM (OR = 3.91, 95% CI: 2.50-6.10). The risk of death is three times higher for patients with COVID-19 and CVD. High mortality risk is also linked to diabetes and hypertension but for chronic kidney disease patients increased up to four times.
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