tetano
Editor, Senior Moderator
Cureus
. 2021 Feb 18;13(2):e13420.
doi: 10.7759/cureus.13420.
COVID-19 Outcomes Amongst Patients With Pre-existing Cardiovascular Disease and Hypertension
Raja Chandra Chakinala[SUP] 1 2 [/SUP], Chail D Shah[SUP] 3 [/SUP], Jigisha H Rakholiya[SUP] 4 [/SUP], Mehwish Martin[SUP] 5 [/SUP], Nirmaljot Kaur[SUP] 6 [/SUP], Harmandeep Singh[SUP] 7 [/SUP], Toochukwu L Okafor[SUP] 8 [/SUP], Chika Nwodika[SUP] 9 [/SUP], Payu Raval[SUP] 10 [/SUP], Salma Yousuf[SUP] 5 [/SUP], Komal Lakhani[SUP] 11 [/SUP], Angelina Yogarajah[SUP] 12 [/SUP], Preeti Malik[SUP] 5 13 [/SUP], Jagmeet Singh[SUP] 14 [/SUP], Asim Kichloo[SUP] 15 [/SUP], Urvish K Patel[SUP] 16 [/SUP]
Affiliations
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) has multiorgan involvement and its severity varies with the presence of pre-existing risk factors like cardiovascular disease (CVD) and hypertension (HTN). Therefore, it is important to evaluate their effect on outcomes of COVID-19 patients. The objective of this meta-analysis and meta-regression is to evaluate outcomes of COVID-19 amongst patients with CVD and HTN.
Methods: English full-text observational studies having data on epidemiological characteristics of patients with COVID-19 were identified searching PubMed from December 1, 2019, to July 31, 2020, following Meta-analysis Of Observational Studies in Epidemiology (MOOSE) protocol. Studies having pre-existing CVD and HTN data that described outcomes including mortality and invasive mechanical ventilation (IMV) utilization were selected. Using random-effects models, risk of composite poor outcomes (meta-analysis) and isolated mortality and IMV utilization (meta-regression) were evaluated. Pooled prevalence of CVD and HTN, correlation coefficient (r) and odds ratio (OR) were estimated. The forest plots and correlation plots were created using random-effects models.
Results: Out of 29 studies (n=27,950) that met the criteria, 28 and 27 studies had data on CVD and HTN, respectively. Pooled prevalence of CVD was 18.2% and HTN was 32.7%. In meta-analysis, CVD (OR: 3.36; 95% CI: 2.29-4.94) and HTN (OR: 1.94; 95% CI: 1.57-2.40) were associated with composite poor outcome. In age-adjusted meta-regression, pre-existing CVD was having significantly higher correlation of IMV utilization (r: 0.28; OR: 1.3; 95% CI: 1.1-1.6) without having any association with mortality (r: -0.01; OR: 0.9; 95% CI: 0.9-1.1) among COVID-19 hospitalizations. HTN was neither correlated with higher IMV utilization (r: 0.01; OR: 1.0; 95% CI: 0.9-1.1) nor correlated with higher mortality (r: 0.001; OR: 1.0; 95% CI: 0.9-1.1).
Conclusion: In age-adjusted analysis, though we identified pre-existing CVD as a risk factor for higher utilization of mechanical ventilation, pre-existing CVD and HTN had no independent role in increasing mortality.
Keywords: 2019-ncov; atrial fibrillation; cardiovascular disease; coronavirus disease 2019 (covid-19); hypertension; invasive mechanical ventilation; novel coronavirus disease 2019; risk factors; sars-cov-2; systematic review and meta-analysis.
. 2021 Feb 18;13(2):e13420.
doi: 10.7759/cureus.13420.
COVID-19 Outcomes Amongst Patients With Pre-existing Cardiovascular Disease and Hypertension
Raja Chandra Chakinala[SUP] 1 2 [/SUP], Chail D Shah[SUP] 3 [/SUP], Jigisha H Rakholiya[SUP] 4 [/SUP], Mehwish Martin[SUP] 5 [/SUP], Nirmaljot Kaur[SUP] 6 [/SUP], Harmandeep Singh[SUP] 7 [/SUP], Toochukwu L Okafor[SUP] 8 [/SUP], Chika Nwodika[SUP] 9 [/SUP], Payu Raval[SUP] 10 [/SUP], Salma Yousuf[SUP] 5 [/SUP], Komal Lakhani[SUP] 11 [/SUP], Angelina Yogarajah[SUP] 12 [/SUP], Preeti Malik[SUP] 5 13 [/SUP], Jagmeet Singh[SUP] 14 [/SUP], Asim Kichloo[SUP] 15 [/SUP], Urvish K Patel[SUP] 16 [/SUP]
Affiliations
- PMID: 33763316
- PMCID: PMC7980770
- DOI: 10.7759/cureus.13420
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) has multiorgan involvement and its severity varies with the presence of pre-existing risk factors like cardiovascular disease (CVD) and hypertension (HTN). Therefore, it is important to evaluate their effect on outcomes of COVID-19 patients. The objective of this meta-analysis and meta-regression is to evaluate outcomes of COVID-19 amongst patients with CVD and HTN.
Methods: English full-text observational studies having data on epidemiological characteristics of patients with COVID-19 were identified searching PubMed from December 1, 2019, to July 31, 2020, following Meta-analysis Of Observational Studies in Epidemiology (MOOSE) protocol. Studies having pre-existing CVD and HTN data that described outcomes including mortality and invasive mechanical ventilation (IMV) utilization were selected. Using random-effects models, risk of composite poor outcomes (meta-analysis) and isolated mortality and IMV utilization (meta-regression) were evaluated. Pooled prevalence of CVD and HTN, correlation coefficient (r) and odds ratio (OR) were estimated. The forest plots and correlation plots were created using random-effects models.
Results: Out of 29 studies (n=27,950) that met the criteria, 28 and 27 studies had data on CVD and HTN, respectively. Pooled prevalence of CVD was 18.2% and HTN was 32.7%. In meta-analysis, CVD (OR: 3.36; 95% CI: 2.29-4.94) and HTN (OR: 1.94; 95% CI: 1.57-2.40) were associated with composite poor outcome. In age-adjusted meta-regression, pre-existing CVD was having significantly higher correlation of IMV utilization (r: 0.28; OR: 1.3; 95% CI: 1.1-1.6) without having any association with mortality (r: -0.01; OR: 0.9; 95% CI: 0.9-1.1) among COVID-19 hospitalizations. HTN was neither correlated with higher IMV utilization (r: 0.01; OR: 1.0; 95% CI: 0.9-1.1) nor correlated with higher mortality (r: 0.001; OR: 1.0; 95% CI: 0.9-1.1).
Conclusion: In age-adjusted analysis, though we identified pre-existing CVD as a risk factor for higher utilization of mechanical ventilation, pre-existing CVD and HTN had no independent role in increasing mortality.
Keywords: 2019-ncov; atrial fibrillation; cardiovascular disease; coronavirus disease 2019 (covid-19); hypertension; invasive mechanical ventilation; novel coronavirus disease 2019; risk factors; sars-cov-2; systematic review and meta-analysis.