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Meta-Analysis
. 2020 Aug;106(15):1142-1147.
doi: 10.1136/heartjnl-2020-317062. Epub 2020 May 27.

Impact of cardiovascular disease and cardiac injury on in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis

Xintao Li #  1 , Bo Guan #  1 , Tong Su  1 , Wei Liu  1 , Mengyao Chen  2 , Khalid Bin Waleed  3 , Xumin Guan  3 , Tse Gary  4 , Zhenyan Zhu  5
Affiliations
Meta-Analysis

Impact of cardiovascular disease and cardiac injury on in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis

Xintao Li et al. Heart. 2020 Aug.

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; I2=29%; unadjusted OR 3.67, 95% CI 2.31 to 5.83; I2=57%, respectively). Acute cardiac injury was also associated with a higher unadjusted odds of 21.15 (95% CI 10.19 to 43.94; I2=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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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-analyses flow diagram of study selection.
Figure 2
Figure 2
Forest plot of the relationship between pre-existing cardiovascular disease and in-hospital mortality risk in patients with COVID-19.
Figure 3
Figure 3
Forest plot of the relationship between previous hypertension and in-hospital mortality risk in patients with COVID-19.
Figure 4
Figure 4
Forest plot of the relationship between acute cardiac injury and in-hospital mortality risk in patients with COVID-19.
See this image and copyright information in PMC

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