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Heart Impact of Cardiovascular Disease and Cardiac Injury on In-Hospital Mortality in Patients With COVID-19: A Systematic Review and Meta-Analysis

tetano

Editor, Senior Moderator
Heart


. 2020 May 27;heartjnl-2020-317062.
doi: 10.1136/heartjnl-2020-317062. Online ahead of print.
Impact of Cardiovascular Disease and Cardiac Injury on In-Hospital Mortality in Patients With COVID-19: A Systematic Review and Meta-Analysis


Xintao Li[SUP] #[/SUP][SUP] 1 [/SUP], Bo Guan[SUP] #[/SUP][SUP] 1 [/SUP], Tong Su[SUP] 1 [/SUP], Wei Liu[SUP] 1 [/SUP], Mengyao Chen[SUP] 2 [/SUP], Khalid Bin Waleed[SUP] 3 [/SUP], Xumin Guan[SUP] 3 [/SUP], Tse Gary[SUP] 4 [/SUP], Zhenyan Zhu[SUP] 5 [/SUP]



Affiliations

Abstract

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[SUP]2[/SUP]=29%; unadjusted OR 3.67, 95% CI 2.31 to 5.83; I[SUP]2[/SUP]=57%, respectively). Acute cardiac injury was also associated with a higher unadjusted odds of 21.15 (95% CI 10.19 to 43.94; I[SUP]2[/SUP]=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.

Keywords: cardiac risk factors and prevention; epidemiology; global health; meta-analysis.
 
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