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Meta-Analysis
. 2023 May;48(3):243-267.
doi: 10.30476/IJMS.2022.93701.2504.

Prevalence of Cardiovascular Complications in Coronavirus Disease 2019 adult Patients: A Systematic Review and Meta-Analysis

Camellia Torabizadeh  1 , Raziyeh Iloonkashkooli  2 , Hajar Haghshenas  2 , Mohammad Fararouei  3
Affiliations
Meta-Analysis

Prevalence of Cardiovascular Complications in Coronavirus Disease 2019 adult Patients: A Systematic Review and Meta-Analysis

Camellia Torabizadeh et al. Iran J Med Sci. 2023 May.

Abstract

Background: It has been found that the new coronavirus can affect various parts of the cardiovascular system. Cardiovascular complications caused by coronavirus disease 2019 (COVID-19) are often serious and can increase the mortality rate among infected patients. This study aimed to investigate the prevalence of cardiovascular complications in COVID-19 adult patients.

Methods: A systematic review and meta-analysis of observational studies published in English were conducted between December 2019 and February 2021. A complete search was performed in PubMed (PubMed Central and MEDLINE), Google Scholar, Cochrane Library, Science Direct, Ovid, Embase, Scopus, CINAHL, Web of Science, and WILEY, as well as BioRXiv, MedRXiv, and gray literature. A random effect model was used to examine the prevalence of cardiovascular complications among COVID-19 patients. The I2 test was used to measure heterogeneity across the included studies.

Results: A total of 74 studies involving 34,379 COVID-19 patients were included for meta-analysis. The mean age of the participants was 61.30±14.75 years. The overall pooled prevalence of cardiovascular complications was 23.45%. The most prevalent complications were acute myocardial injury (AMI) (19.38%, 95% CI=13.62-26.81, test for heterogeneity I2=97.5%, P<0.001), arrhythmia (11.16%, 95% CI=8.23-14.96, test for heterogeneity I2=91.5%, P<0.001), heart failure (HF) (7.56%, 95% CI=4.50-12.45, test for heterogeneity I2=96.3%, P<0.001), and cardiomyopathy (2.78%, 95% CI=0.34-9.68). The highest pooled prevalence of cardiac enzymes was lactate dehydrogenase (61.45%), troponin (23.10%), and creatine kinase-myocardial band or creatine kinase (14.52%).

Conclusion: The high prevalence of serious cardiovascular complications in COVID-19 patients (AMI, arrhythmia, and HF) necessitates increased awareness by healthcare administrators.

Keywords: Biomarkers; COVID-19; Cardiovascular system; Prevalence.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
The flow diagram shows the study selection strategies according to the PRISMA guidelines.
Figure 2
Figure 2
Forest plots show the overall prevalence of cardiovascular complications in patients with COVID-19 (pooled prevalence, as well as a, b, and c groups, are sorted by the sample size of the studies).
Figure 3
Figure 3
Forest plots show the prevalence of acute cardiac (myocardial) injury (ACI/AMI) in patients with COVID-19 (pooled prevalence, as well as a, b, and c groups, are sorted by the sample size of the studies).
Figure 4
Figure 4
The forest plot shows the prevalence of cardiac arrhythmia in patients with COVID-19.
Figure 5
Figure 5
The forest plot shows the prevalence of heart failure in patients with COVID-19.
Figure 6
Figure 6
The forest plot shows the prevalence of myocardial infarction (M.Inf.) in patients with COVID-19.
Figure 7
Figure 7
The forest plot shows the prevalence of myocarditis in patients with COVID-19.
Figure 8
Figure 8
The forest plot shows the prevalence of increased lactate dehydrogenase levels in patients with COVID-19.
Figure 9
Figure 9
Forest plots show the prevalence of increased cTnI(T) level in patients with COVID-19 (pooled prevalence, as well as a, b, and c groups, were sorted by the sample size of the studies).
Figure 10
Figure 10
The forest plot shows the prevalence of increased creatine kinase or creatine kinase-myocardial band level in patients with COVID-19.
See this image and copyright information in PMC

References

    1. Velavan TP, Meyer CG. The COVID-19 epidemic. Trop Med Int Health. 2020;25:278–80. doi: 10.1111/tmi.13383. [ PMC Free Article ] - DOI - PMC - PubMed
    1. Clerkin KJ, Fried JA, Raikhelkar J, Sayer G, Griffin JM, Masoumi A, et al. COVID-19 and Cardiovascular Disease. Circulation. 2020;141:1648–55. doi: 10.1161/CIRCULATIONAHA.120.046941. - DOI - PubMed
    1. Patel AB, Verma A. COVID-19 and Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers: What Is the Evidence? JAMA. 2020;323:1769–70. doi: 10.1001/jama.2020.4812. - DOI - PubMed
    1. Inciardi RM, Lupi L, Zaccone G, Italia L, Raffo M, Tomasoni D, et al. Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19) JAMA Cardiol. 2020;5:819–24. doi: 10.1001/jamacardio.2020.1096. [ PMC Free Article ] - DOI - PMC - PubMed
    1. Eisenhut M. Extrapulmonary manifestations of severe respiratory syncytial virus infection--a systematic review. Crit Care. 2006;10:R107. doi: 10.1186/cc4984. [ PMC Free Article ] - DOI - PMC - PubMed

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