TY - JOUR
T1 - Impact of cardiovascular disease and cardiac injury on in-hospital mortality in patients with COVID-19
T2 - A systematic review and meta-analysis
AU - Li, Xintao
AU - Guan, Bo
AU - Su, Tong
AU - Liu, Wei
AU - Chen, Mengyao
AU - Bin Waleed, Khalid
AU - Guan, Xumin
AU - Gary, Tse
AU - Zhu, Zhenyan
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Background Coronavirus disease 2019 (COVID-19) has produced a significant health burden worldwide, especially in patients with cardiovascular comorbidities. The aim of this systematic review and meta-analysis was to assess the impact of underlying cardiovascular comorbidities and acute cardiac injury on in-hospital mortality risk. Methods PubMed, Embase and Web of Science were searched for publications that reported the relationship of underlying cardiovascular disease (CVD), hypertension and myocardial injury with in-hospital fatal outcomes in patients with COVID-19. The ORs were extracted and pooled. Subgroup and sensitivity analyses were performed to explore the potential sources of heterogeneity. Results A total of 10 studies were enrolled in this meta-analysis, including eight studies for CVD, seven for hypertension and eight for acute cardiac injury. The presence of CVD and hypertension was associated with higher odds of in-hospital mortality (unadjusted OR 4.85, 95% CI 3.07 to 7.70; I 2 =29%; unadjusted OR 3.67, 95% CI 2.31 to 5.83; I 2 =57%, respectively). Acute cardiac injury was also associated with a higher unadjusted odds of 21.15 (95% CI 10.19 to 43.94; I 2 =71%). Conclusion COVID-19 patients with underlying cardiovascular comorbidities, including CVD and hypertension, may face a greater risk of fatal outcomes. Acute cardiac injury may act as a marker of mortality risk. Given the unadjusted results of our meta-analysis, future research are warranted.
AB - Background Coronavirus disease 2019 (COVID-19) has produced a significant health burden worldwide, especially in patients with cardiovascular comorbidities. The aim of this systematic review and meta-analysis was to assess the impact of underlying cardiovascular comorbidities and acute cardiac injury on in-hospital mortality risk. Methods PubMed, Embase and Web of Science were searched for publications that reported the relationship of underlying cardiovascular disease (CVD), hypertension and myocardial injury with in-hospital fatal outcomes in patients with COVID-19. The ORs were extracted and pooled. Subgroup and sensitivity analyses were performed to explore the potential sources of heterogeneity. Results A total of 10 studies were enrolled in this meta-analysis, including eight studies for CVD, seven for hypertension and eight for acute cardiac injury. The presence of CVD and hypertension was associated with higher odds of in-hospital mortality (unadjusted OR 4.85, 95% CI 3.07 to 7.70; I 2 =29%; unadjusted OR 3.67, 95% CI 2.31 to 5.83; I 2 =57%, respectively). Acute cardiac injury was also associated with a higher unadjusted odds of 21.15 (95% CI 10.19 to 43.94; I 2 =71%). Conclusion COVID-19 patients with underlying cardiovascular comorbidities, including CVD and hypertension, may face a greater risk of fatal outcomes. Acute cardiac injury may act as a marker of mortality risk. Given the unadjusted results of our meta-analysis, future research are warranted.
KW - cardiac risk factors and prevention
KW - epidemiology
KW - global health
KW - meta-analysis
UR - http://www.scopus.com/inward/record.url?scp=85085656477&partnerID=8YFLogxK
U2 - 10.1136/heartjnl-2020-317062
DO - 10.1136/heartjnl-2020-317062
M3 - Article
C2 - 32461330
AN - SCOPUS:85085656477
SN - 1355-6037
VL - 106
SP - 1142
EP - 1147
JO - Heart
JF - Heart
IS - 15
ER -
