Background and aims
Emerging data have linked the presence of cardiac injury with a worse prognosis in COVID-19 patients. However, available data cannot clearly characterize the correlation between cardiac injury and COVID-19. Thus, we conducted a meta-analysis of recent studies to 1) explore the prevalence of cardiac injury in different types of COVID-19 patients and 2) evaluate the association between cardiac injury and worse prognosis (severe disease, admission to ICU, and mortality) in patients with COVID-19.
Methods and results
Literature searched was conducted through PubMed, the Cochrane Library, Embase, and MedRxiv databases. Meta-analysis was performed with Stata 14.0. Fixed-effects model was used if the
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values ≤50%, otherwise the random-effects model was performed.Prevalence of cardiac injury was 19% (95%CI:0.15-0.22, p<0.001) in total COVID-19 patients, 36% (95%CI:0.25-0.47, p<0.001) in severe COVID-19 patients, and 48% (95%CI:0.30-0.66, p<0.001) in non-survivors. Furthermore, cardiac injury was found to be associated with a significant increase in risk of poor outcomes with pooled effect size(ES) of 8.46(95%CI:3.76-19.06, p=0.062), severe disease with ES of 3.54(95% CI:2.25-5.58, p<0.001), admission to ICU with ES of 5.03(95% CI:2.69-9.39,p<0.001), and mortality with ES of 4.99(95% CI:3.38-7.37, p<0.001).
Conclusions
Prevalence of cardiac injury was greatly increased in COVID-19 patients, particularly in patients with severe disease and non-survivors. COVID-19 patients with cardiac injury are more likely to be associated with poor outcomes, severity of disease, admission to ICU, and mortality.