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Meta-Analysis
. 2021 Apr;23(2):258-269.
doi: 10.1177/1099800420951984. Epub 2020 Aug 27.

Cardio-Cerebrovascular Disease is Associated With Severity and Mortality of COVID-19: A Systematic Review and Meta-Analysis

Jia-Ning Yu  1 , Bing-Bing Wu  1 , Jie Yang  1 , Xiao-Ling Lei  1 , Wang-Qin Shen  1
Affiliations
Meta-Analysis

Cardio-Cerebrovascular Disease is Associated With Severity and Mortality of COVID-19: A Systematic Review and Meta-Analysis

Jia-Ning Yu et al. Biol Res Nurs. 2021 Apr.

Abstract

At present, COVID-19 is raging all over the world. Many comorbidities, such as diabetes mellitus (OR = 2.67, 95% CI = 1.91-3.74) and hypertension (OR = 2.3, 95% CI = 1.76-3.00), have been shown to worsen the patient's condition. However, whether cardio-cerebrovascular disease will affect COVID-19 remains unclear. In this meta-analysis, we collected studies from PubMed, Wed of Science and CNKI (Chinese) to July 25, which reported COVID-19 patients with and without cardio-cerebrovascular disease as well as their severity and mortality. The random-effect model meta-analysis was used to analyze them and get overall odds ratios (OR) with 95% CIs. Funnel plots and the Begg's and Egger's test were used to assess publication bias. Thirty-one studies with 23,632 patients were finally included in the meta-analysis. The results showed an OR of 3.004 (95% CI = 2.097-4.303) for COVID-19 severity and an OR of 5.587 (95% CI = 2.810-11.112) for COVID-19 mortality. Compared with cardiovascular disease, the subgroup analysis indicated that cerebrovascular disease was more likely to increase the severity (OR = 3.400, 95% CI = 1.569-7.368) and mortality (OR = 23.477, 95% CI = 3.050-180.735) of COVID-19. Therefore, it can be inferred that cardio-cerebrovascular disease is associated with an increase in the risk of severe illness and death among COVID-19 patients. This meta-analysis showed that cardio-cerebrovascular disease has a significant relation with severe and death outcomes of COVID-19. Nurses should pay special attention to COVID-19 patients with the cardio-cerebrovascular disease.

Keywords: COVID-19; cardio-cerebrovascular disease; meta-analysis; severity; mortality.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow diagram of the study selection and exclusion process.
Figure 2.
Figure 2.
Forest plot for cardio-cerebrovascular disease and COVID-19.
Figure 3.
Figure 3.
Funnel plot of cardio-cerebrovascular disease and COVID-19.
Figure 4.
Figure 4.
Subgroup analysis by the type of cardio-cerebrovascular disease.
Figure 5.
Figure 5.
Sensitivity analysis for cardio-cerebrovascular disease and COVID-19.
Figure 6.
Figure 6.
Meta-regression analysis for patients’ median age (years).
See this image and copyright information in PMC

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