Associations of pre-existing cardiovascular morbidity with severity and the fatality rate in COVID-19 patients: a systematic review and meta-analysis

다국어 초록 (Multilingual Abstract)

Objectives: The aim of this study was to evaluate the association of pre-existing cardiovascular comorbidities, including hypertension and coronary heart disease, with coronavirus disease 2019 (COVID-19) severity and mortality.
Methods: PubMed, ScienceDirect, and Scopus were searched between January 1, 2020, and July 18, 2020, to identify eligible studies. Random-effect models were used to estimate the pooled event rates of pre-existing cardiovascular disease comorbidities and odds ratio (OR) with 95% confidence intervals (95% CIs) of disease severity and mortality associated with the exposures of interest.
Results: A total of 34 studies involving 19,156 patients with COVID-19 infection met the inclusion criteria. The prevalence of pre-existing cardiovascular disease in the included studies was 14.0%. Pre-existing cardiovascular disease in COVID-19 patients was associated with severe outcomes (OR, 4.1; 95% CI, 2.9 to 5.7) and mortality (OR, 6.1; 95% CI, 2.9 to 12.7). Hypertension and coronary heart disease increased the risk of severe outcomes by 2.6 times (OR, 2.6; 95% CI, 1.9 to 3.6) and 2.5 times (OR, 2.5; 95% CI, 1.7 to 3.8), respectively. No significant publication bias was indicated.
Conclusion: COVID-19 patients with pre-existing cardiovascular comorbidities have a higher risk of severe outcomes and mortality. Awareness of pre-existing cardiovascular comorbidity is important for the early management of COVID-19.

참고문헌 (Reference)

1 Enzmann MO, "Treatment and preliminary outcomes of 150 acute care patients with COVID-19 in a rural health system in the Dakotas" 148 : e124-, 2020

2 Luo L, "The potential association between common comorbidities and severity and mortality of coronavirus disease 2019 : a pooled analysis" 43 : 1478-1493, 2020

3 Alanagreh L, "The human coronavirus disease COVID-19: its origin, characteristics, and insights into potential drugs and its mechanisms" 9 : 331-, 2020

4 Mercuro NJ, "Risk of QT interval prolongation associated with use of hydroxychloroquine with or without concomitant azithromycin among hospitalized patients testing positive for coronavirus disease 2019(COVID-19)" 5 : 1036-1041, 2020

5 Zheng Z, "Risk factors of critical & mortal COVID-19 cases : a systematic literature review and meta-analysis" 81 : e16-e25, 2020

6 Hu L, "Risk factors associated with clinical outcomes in 323 coronavirus disease 2019 (COVID-19) hospitalized patients in Wuhan, China" 71 : 2089-2098, 2020

7 Vaduganathan M, "Renin-angiotensin-aldosterone system inhibitors in patients with COVID-19" 382 : 1653-1659, 2020

8 Higgins JP, "Quantifying heterogeneity in a meta-analysis" 21 : 1539-1558, 2002

9 Han H, "Prominent changes in blood coagulation of patients with SARS-CoV-2 infection" 58 : 1116-1120, 2020

10 Yang J, "Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2 : a systematic review and meta-analysis" 94 : 91-95, 2020

11 Li B, "Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China" 109 : 531-538, 2020

12 Richardson S, "Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York city area" 323 : 2052-2059, 2020

13 Moher D, "Preferred reporting items for systematic reviews and meta-analyses : the PRISMA statement" 6 : e1000097-, 2009

14 Zhang Z, "Platelet indices are novel predictors of hospital mortality in intensive care unit patients" 29 : 885-, 2014

15 Munn Z, "Methodological quality of case series studies : an introduction to the JBI critical appraisal tool" 18 : 2127-2133, 2020

16 Ganatra S, "Management of cardiovascular disease during coronavirus disease(COVID-19)pandemic" 30 : 315-325, 2020

17 Sala S, "Low prevalence of arrhythmias in clinically stable COVID-19 patients" 43 : 891-893, 2020

18 Yu Y, "Identification of risk factors for mortality associated with COVID-19" 8 : e9885-, 2020

19 Jin X, "Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms" 69 : 1002-1009, 2020

20 Chen N, "Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study" 395 : 507-513, 2020

21 Saleh M, "Effect of chloroquine, hydroxychloroquine, and azithromycin on the corrected QT interval in patients with SARS-CoV-2 infection" 13 : e008662-, 2020

22 Lagi F, "Early experience of an infectious and tropical diseases unit during the coronavirus disease (COVID-19) pandemic, Florence, Italy, February to March 2020" 25 : 2000556-, 2020

23 Qin C, "Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China" 71 : 762-768, 2020

24 Shah SJ, "Current trends of hypertension treatment in the United States" 30 : 1008-1014, 2017

25 Alzoughool F, "Coronavirus drugs : using plasma from recovered patients as a treatment for COVID-19" 31 : 47-51, 2020

26 Guan WJ, "Comorbidity and its impact on 1590 patients with COVID-19 in China : a nationwide analysis" 55 : 2000547-, 2020

27 Huang C, "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China" 395 : 497-506, 2020

28 Du Y, "Clinical features of 85 fatal cases of COVID-19 from Wuhan : a retrospective observational study" 201 : 1372-1379, 2020

29 Wan S, "Clinical features and treatment of COVID-19 patients in northeast Chongqing" 92 : 797-806, 2020

30 Zhang G, "Clinical features and short-term outcomes of 221 patients with COVID-19 in Wuhan, China" 127 : 104364-, 2020

31 Zhou F, "Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study" 395 : 1054-1062, 2020

32 Yang X, "Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study" 8 : 475-481, 2020

33 Wang Y, "Clinical course and outcomes of 344 intensive care patients with COVID-19" 201 : 1430-1434, 2020

34 Wang D, "Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China" 24 : 188-, 2020

35 Guan WJ, "Clinical characteristics of coronavirus disease 2019 in China" 382 : 1708-1720, 2020

36 Goyal P, "Clinical characteristics of COVID-19 in New York city" 382 : 2372-2374, 2020

37 Zhang JJ, "Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China" 75 : 1730-1741, 2020

38 Wang D, "Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China" 323 : 1061-1069, 2020

39 Yan Y, "Clinical characteristics and outcomes of patients with severe covid-19 with diabetes" 8 : e001343-, 2020

40 Lei S, "Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection" 21 : 100331-, 2020

41 Chen T, "Clinical characteristics and outcomes of older patients with coronavirus disease 2019 (COVID-19) in Wuhan, China: a single-centered, retrospective study" 75 : 1788-1795, 2020

42 Inciardi RM, "Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy" 41 : 1821-1829, 2020

43 Gold JA, "Characteristics and clinical outcomes of adult patients hospitalized with COVID-19: Georgia, March 2020" 69 : 545-550, 2020

44 Guo T, "Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19)" 5 : 811-818, 2020

45 Bhatla A, "COVID-19 and cardiac arrhythmias" 17 : 1439-1444, 2020

46 Grasselli G, "Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy region, Italy" 323 : 1574-1581, 2020

47 Rosenberg ES, "Association of treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with COVID-19 in New York state" 323 : 2493-2502, 2020

48 Thathapudi S, "Association of luteinizing hormone chorionic gonadotropin receptor gene polymorphism(rs2293275)with polycystic ovarian syndrome" 19 : 128-132, 2015

49 Shi S, "Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China" 5 : 802-810, 2020

50 Mishra AK, "A review of cardiac manifestations and predictors of outcome in patients with COVID-19" 49 : 848-852, 2020

51 Lang JP, "A current review of COVID-19 for the cardiovascular specialist" 226 : 29-44, 2020

52 Huang Y, "A cohort study of 223 patients explores the clinical risk factors for the severity diagnosis of COVID-19"