Cardiovascular Outcomes Associated with Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis
Author(s)
Alkofide H1, Almesned R1, Alnoghaimshi L2, Alkherb Z1, Alhindi G3, Korayem G4
1King Saud University, Riyadh, Saudi Arabia, 2King Saud University, Riyadh , Saudi Arabia, 3KSP, Riyadh, Saudi Arabia, 4Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
OBJECTIVES Studies show a trend towards higher incidences of cardiac complications in hospitalized patients with coronavirus disease 2019 (COVID-19). However, it remains unclear if there is a strong association with the severity of COVID-19. Therefore, this systematic review and meta-analysis aim to identify the cardiovascular complications associated with COVID-19. Our overall goal is to highlight the need to effectively monitor and treat cardiac abnormalities in subjects with this infection to prevent deaths and related complications. METHODS We have systematically searched databases, including Medline, Google scholar, and MedRxiv. Identified studies were screened independently by two investigators. Observational studies that reported on the outcome of myocardial injury or heart failure, comparing between severe and non-severe COVID-19 patients, were considered eligible. Demographic information, comorbidities, and cardiac outcomes were extracted from eligible studies. Quality assessment was performed using the Newcastle–Ottawa quality assessment scale for Cohort and Case-Control studies and AXIS tool for cross-sectional studies. Random-effects model was used when pooling crude numbers of myocardial injury or heart failure. Statistical heterogeneity between groups was measured using the I2 statistic. RESULTS The search identified 1502 potentially eligible studies. Fifteen studies with a total of 2,226 patients were included in this meta-analysis. The overall incidence of acute myocardial injury was 400 (17.9%) in hospitalized COVID-19 patients. The outcome of acute myocardial injury was significantly higher among patients with severe COVID-19 compared to non-severe cases (47.8% vs 5.8%, P<0.001) with a risk ratio (RR) of 7.4, 95% confidence interval (CI)=4.7-11.5, and an I2 of 64.4%. The incidence of heart failure was 46.5% in severe COVID-19 cases and 10.2% in non-severe cases, (RR=5.0, 95% CI=2.6-9.7, I2=69.6). CONCLUSIONS Severity of COVID-19 can significantly impact the development of cardiac complications, this highlights the importance of early identification and monitoring of cardiac abnormalities, to improve health outcomes of COVID-19 patients.
Conference/Value in Health Info
2021-05, ISPOR 2021, Montreal, Canada
Value in Health, Volume 24, Issue 5, S1 (May 2021)
Code
PCV40
Topic
Epidemiology & Public Health
Disease
Cardiovascular Disorders, Infectious Disease (non-vaccine), Respiratory-Related Disorders