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. 2021 Jun 11;156(11):547-554.
doi: 10.1016/j.medcle.2020.12.021. Epub 2021 Jun 5.

Coronary heart disease and COVID-19: A meta-analysis

Chendi Liang  1 , Weijun Zhang  2 , Shuzhen Li  3 , Gang Qin  2
Affiliations

Coronary heart disease and COVID-19: A meta-analysis

Chendi Liang et al. Med Clin (Engl Ed). .

Abstract
in English, Spanish

Objective: Since the World Health Organization (WHO) announced coronavirus disease 2019 (COVID-19) had become a global pandemic on March 11, 2020, the number of infections has been increasing. The purpose of this meta-analysis was to investigate the prognosis of COVID-19 in patients with coronary heart disease.

Method: Pubmed, Embase, and Cochrane Library databases were searched to collect the literature concerning coronary heart disease and COVID-19. The retrieval time was from inception to Nov 20, 2020, using Stata version 14.0 for meta-analysis.

Results: A total of 22,148 patients from 40 studies were included. The meta-analysis revealed that coronary heart disease was associated with poor prognosis of COVID-19 (OR=3.42, 95%CI [2.83, 4.13], P < 0.001). After subgroup analysis, coronary heart disease was found to be related to mortality (OR = 3.75, 95%CI [2.91, 4.82], P < 0.001), severe/critical COVID-19 (OR = 3.23, 95%CI [2.19, 4.77], P < 0.001), ICU admission (OR = 2.25, 95%CI [1.34, 3.79], P = 0.002), disease progression (OR = 3.01, 95%CI [1.46, 6.22], P = 0.003); Meta-regression showed that the association between coronary heart disease and poor prognosis of COVID-19 was affected by hypertension (P = 0.004), and subgroup analysis showed that compared with the proportion of hypertension >30% (OR = 2.85, 95%CI [2.33, 3.49]), the proportion of hypertension <30% (OR = 4.78, 95%CI [3.50, 6.51]) had a higher risk of poor prognosis.

Conclusion: Coronary heart disease is a risk factor for poor prognosis in patients with COVID-19.

Objetivo: Desde que la Organización Mundial de la Salud (OMS) anunció que la enfermedad por coronavirus de 2019 (COVID-19) se había convertido en una pandemia global el 11 de marzo de 2020, se ha incrementado el número de infecciones. El objetivo de este metaanálisis fue investigar el pronóstico de la COVID-19 en pacientes con cardiopatía coronaria.

Método: Se realizó una búsqueda en las bases de datos de Pubmed, Embase y Cochrane Library para reunir la literatura relativa a cardiopatía coronaria y COVID-19. El tiempo de recuperación de datos fue desde el inicio hasta el 20 de noviembre de 2020, utilizando la versión 14.0 de Stata® para el metaanálisis.

Resultados: Se incluyó un total de 22.148 pacientes de 40 estudios. El metaanálisis reveló que la cardiopatía coronaria estaba asociada a un mal pronóstico de COVID-19 (OR: 3,42; IC 95%: 2,83-4,13; p < 0,001). Tras el análisis de subgrupo, se encontró que la cardiopatía coronaria tenía relación con la mortalidad (OR: 3,75; IC 95%: 2,91-4,82; p < 0,001), COVID-19 grave/crítica (OR: 3,23; IC 95%: 2,19-4,77; p < 0,001), ingreso en la UCI (OR: 2,25; IC 95%: 1,34-3,79; p = 0,002), progresión de la enfermedad (OR: 3,01; IC 95%: 1,46-6,22; p = 0,003). La metarregresión reflejó que la asociación entre cardiopatía coronaria y mal pronóstico de la COVID-19 estaba influida por la hipertensión (p = 0,004), y el análisis de subgrupo mostró que comparada con la proporción de hipertensión > 30% (OR: 2,85; IC 95%: 2,33-3,49), la proporción de hipertensión < 30% (OR: 4,78; IC 95%: 3,50-6,51) tenía mayor riesgo de mal pronóstico.

Conclusión: La cardiopatía coronaria es un factor de riesgo de mal pronóstico en pacientes con COVID-19.

Keywords: COVID-19; Coronary heart disease; Meta-analysis.

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Figures

Fig. 1
Fig. 1
Flow chart of the screening process.
Fig. 2
Fig. 2
Forest plot of the relationship between coronary heart disease and the prognosis of COVID-19.
Fig. 3
Fig. 3
Subgroup analysis based on meta-regression results.
Fig. 4
Fig. 4
Publication bias analysis. (A) For the relationship between coronary heart disease and prognosis of COVID-19, a funnel plot was used to qualitatively assess publication bias. (B) For the relationship between coronary heart disease and prognosis of COVID-19, the Egger test was used to quantitatively assess publication bias (P < 0.001). (C) Trim and fill funnel plot was symmetrical after addition of 10 missing hypothetical studies.
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