4.5 Review

Cardiovascular diseases burden in COVID-19: Systematic review and meta-analysis

Journal

AMERICAN JOURNAL OF EMERGENCY MEDICINE
Volume 46, Issue -, Pages 382-391

Publisher

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.ajem.2020.10.022

Keywords

COVID-19; Cardiovascular disease; Meta-analysis

Funding

  1. Student Research Committee, Mazandaran University of Medical Sciences [7396]

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A systematic review and meta-analysis revealed a high burden of cardiovascular diseases among COVID-19 patients, significantly associated with mortality and ICU admission. Proper monitoring and management of cardiovascular conditions in COVID-19 patients are highly recommended to prevent critical outcomes.
Background: High rate of cardiovascular disease (CVD) have been reported among patients with novel coronavirus disease (COVID-19). Meanwhile there were controversies among different studies about CVD burden in COVID-19 patients. Hence, we aimed to study CVD burden among COVID-19 patients, using a systematic review and meta-analysis. Methods: We have systematically searched databases including PubMed, Embase, Cochrane Library, Scopus, Web of Science as well as medRxiv pre-print database. Hand searched was also conducted in journal websites and Google Scholar. Meta-analyses were carried out for Odds Ratio (OR) of mortality and Intensive Care Unit (ICU) admission for different CVDs. We have also performed a descriptive meta-analysis on different CVDs. Results: Fifty-six studies entered into meta-analysis for ICU admission and mortality outcome and 198 papers for descriptive outcomes, including 159,698 COVID-19 patients. Results of meta-analysis indicated that acute cardiac injury, (OR: 13.29, 95% CI 7.35-24.03), hypertension (OR: 2.60, 95% CI 2.11-3.19), heart Failure (OR: 6.72, 95% CI 3.34-13.52), arrhythmia (OR: 2.75, 95% CI 1.43-5.25), coronary artery disease (OR: 3.78, 95% CI 2.42-5.90), and cardiovascular disease (OR: 2.61, 95% CI 1.89-3.62) were significantly associated with mortality. Arrhythmia (OR: 7.03, 95% CI 2.79-17.69), acute cardiac injury (OR: 15.58, 95% CI 5.15-47.12), coronary heart disease (OR: 2.61, 95% CI 1.09-6.26), cardiovascular disease (OR: 3.11, 95% CI 1.59-6.09), and hypertension (OR: 1.95, 95% CI 1.41-2.68) were also significantly associated with ICU admission in COVID-19 patients. Conclusion: Findings of this study revealed a high burden of CVDs among COVID-19 patients, which was signifi-cantly associated with mortality and ICU admission. Proper management of CVD patients with COVID-19 and monitoring COVID-19 patients for acute cardiac conditions is highly recommended to prevent mortality and critical situations. (c) 2020 Elsevier Inc. All rights reserved.

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