Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Nov;29(11):105283.
doi: 10.1016/j.jstrokecerebrovasdis.2020.105283. Epub 2020 Aug 28.

The Association of Cerebrovascular Disease with Adverse Outcomes in COVID-19 Patients: A Meta-Analysis Based on Adjusted Effect Estimates

Jie Xu  1 , Wenwei Xiao  1 , Xuan Liang  1 , Peihua Zhang  1 , Li Shi  1 , Ying Wang  1 , Yadong Wang  2 , Haiyan Yang  3
Affiliations
Meta-Analysis

The Association of Cerebrovascular Disease with Adverse Outcomes in COVID-19 Patients: A Meta-Analysis Based on Adjusted Effect Estimates

Jie Xu et al. J Stroke Cerebrovasc Dis. 2020 Nov.

Abstract

Objective: The aim of this study was to address the association between cerebrovascular disease and adverse outcomes in coronavirus disease 2019 (COVID-19) patients by using a quantitative meta-analysis based on adjusted effect estimates.

Method: A systematic search was performed in PubMed, Web of Science, and EMBASE up to August 10th, 2020. The adjusted effect estimates were extracted and pooled to evaluate the risk of the unfavorable outcomes in COVID-19 patients with cerebrovascular disease. Subgroup analysis and meta-regression were also carried out.

Results: There were 12 studies with 10,304 patients included in our meta-analysis. A significant trend was observed when evaluating the association between cerebrovascular disease and adverse outcomes (pooled effect = 2.05, 95% confidence interval (CI): 1.34-3.16). In addition, the pooled effects showed that patients with a history of cerebrovascular disease had more likelihood to progress fatal outcomes than patients without a history of cerebrovascular disease (pooled effect = 1.78, 95% CI: 1.04-3.07).

Conclusion: This study for the first time indicated that cerebrovascular disease was an independent risk factor for predicting the adverse outcomes, particularly fatal outcomes, in COVID-19 patients on the basis of adjusted effect estimates. Well-designed studies with larger sample size are needed for further verification.

Keywords: Adjusted effect estimate; Adverse outcomes; COVID-19; Cerebrovascular disease; Meta-analysis.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest All authors report that they have no potential conflicts of interest.

Figures

Fig 1
Fig. 1
Flow diagram of the publication search and selection process.
Fig 2
Fig. 2
(A) Forest plot of adjusted hazard ratios for adverse outcomes associated with cerebrovascular disease in patients with COVID-19. (B) Forest plot of adjusted hazard ratios for in-hospital mortality associated with cerebrovascular disease in patients with COVID-19.
Fig 3
Fig. 3
Sensitivity analysis.
Fig 4
Fig. 4
(A) Begg's test. (B) Egger's test. (C) Deek's plot.
See this image and copyright information in PMC

References

    1. Pandey A.S., Ringer A.J., Rai A.T. Minimizing SARS-CoV-2 exposure when performing surgical interventions during the COVID-19 pandemic. J Neurointerv Surg. 2020;12(7):643–647. doi: 10.1136/neurintsurg-2020-016161. - DOI - PubMed
    1. Marietta M., Vandelli P., Mighali P. Randomised controlled trial comparing efficacy and safety of high versus low Low-Molecular Weight Heparin dosages in hospitalized patients with severe COVID-19 pneumonia and coagulopathy not requiring invasive mechanical ventilation (COVID-19 HD): a structured summary of a study protocol. Trials. 2020;21(1):574. doi: 10.1186/s13063-020-04475-z. - DOI - PMC - PubMed
    1. Khosravani H., Rajendram P., Notario L. Protected code stroke: hyperacute stroke management during the Coronavirus Disease 2019 (COVID-19) pandemic. Stroke. 2020;51(6):1891–1895. doi: 10.1161/strokeaha.120.029838. - DOI - PMC - PubMed
    1. Chen R., Liang W., Jiang M. Risk factors of fatal outcome in hospitalized subjects with Coronavirus Disease 2019 from a nationwide analysis in China. Chest. 2020;158(1):97–105. doi: 10.1016/j.chest.2020.04.010. - DOI - PMC - PubMed
    1. Aggarwal G., Lippi G., Michael Henry B. Cerebrovascular disease is associated with an increased disease severity in patients with Coronavirus Disease 2019 (COVID-19): a pooled analysis of published literature. Int. J. Stroke. 2020;15(4):385–389. doi: 10.1177/1747493020921664. - DOI - PubMed

MeSH terms