Introduction The novel severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has caused a pandemic. Many studies have shown that several laboratory parameters are related to disease severity and mortality in SARS‐CoV‐2 cases. This meta‐analysis aimed to determine the relationship of a prognostic factor, D‐dimer, with disease severity, need for intensive care unit (ICU) care, and mortality in SARS‐CoV‐2 patients. Methods A systematic search for all observational studies and trials involving adult patients with SARS‐CoV‐2 that had any data related to D‐dimer on admission was conducted using PubMed, Science Direct, Scopus, ProQuest, and MedRxiv databases. We performed random‐effects inverse‐variance weighting analysis using mean difference (MD) of D‐dimer values for outcomes such as disease severity, mortality, and need for ICU care. Results A total of 29 studies (4,328 patients) were included in this meta‐analysis, which revealed a higher mean of D‐dimer levels on admission in severe patients than in nonsevere patients (MD = 0.95, [95% confidence interval (CI): 0.61‐1.28], P < .05; I2 = 90%). The nonsurvivor group had a higher pooled MD of D‐dimer values on admission (MD = 5.54 [95% CI: 3.40‐7.67], P < .05; I2 = 90%). Patients who needed ICU admission had insignificantly higher D‐dimer values than patients who did not need ICU admission (MD = 0.29, [95% CI: −0.05 to 0.63], P = .10; I2 = 71%). Conclusion Elevated D‐dimer levels on admission were associated with an increased risk of disease severity and mortality in patients with SARS‐CoV‐2 infection.

INTRODUCTION: COVID-19 is a systemic infection with a significant impact on coagulation which manifests in thromboembolism. There is an unknown relationship of which coagulation profile parameter at presentation has an association with poor outcome in COVID-19. OBJECTIVE: This meta-analysis aimed to determine the relationship between fibrinogen and FDP with poor outcome in COVID-19 patients. METHODS: A systematic search of all observational studies or trials involving adult patients with COVID-19 that had any data fibrinogen or FDP on admission was carried out using the PubMed, Science Direct, Scopus, ProQuest, and MedRxiv databases. We assessed the methodological quality assessment using the NIH Quality Assessment Tool. We performed random-effects inverse-variance weighting analysis using mean difference (MD). RESULTS: A total of 17 studies (1,654 patients) were included in this meta-analysis. It revealed a higher mean of fibrinogen levels on admission in patients with severe case compared to those with non-severe case (MD = 0.69, [95% CI: 0.44 to 0.94], p <  0.05; I2 = 72%, p <  0.05). Non-survivor group had a pooled higher mean difference of fibrinogen values on admission (MD = 0.48 [95% CI: 0.13 to 0.83], p <  0.05; I2 = 38%, p = 0.18). Higher FDP on admission was found in poor outcome (composite of severity, critically ill, and mortality) compared to good outcome (4 studies, MD = 4.84 [95% CI: 0.75 to 8.93], p <  0.05; I2 = 86%, p <  0.05). CONCLUSION: Elevated fibrinogen and FDP level on admission were associated with an increase risk of poor outcome in COVID-19 patients.

Aims This meta-analysis aims to analyze the association of calcium channel blocker (CCB) use with COVID-19 clinical outcomes. Methods PubMed, ProQuest, Science Direct, Scopus, and medRxiv databases were searched systematically in a limited period. The primary outcome was mortality. Results A total of 119,298 patients from 31 eligible studies were included. Pooled analysis of the random-effect model revealed CCB was not associated with reduced mortality (OR = 1.21 [95%CI: 0.98–1.49], p = 0.08). Interestingly, subgroup analysis in hypertensive patients revealed significantly reduced mortality (OR = 0.69 [95%CI: 0.52–0.91], p = 0.009). Conclusion CCB usage was not associated with the outcome of COVID-19. However, CCB was associated with a decreased mortality rate in hypertensive COVID-19 patients.

ObjectivesCardiovascular disease (CVD) complication is common among chronic kidney disease (CKD) patients. Thus, knowledge about CVD and ECG abnormalities in CKD are essential due to progressive nature of the disease and increased risk of sudden cardiac death. This study aims to scrutinize the ECG abnormalities among nondialysis late-stage CKD patients.MethodsA descriptive observational study was conducted at Dr. Soetomo General Hospital, Surabaya, Indonesia. Subjects were hospitalized patients with late-stage CKD between 1 January and 31 December 2019, who were consulted at the department of cardiology and vascular medicine during their initial admission at emergency room. ECG interpretation for this study was done by qualified cardiologist.ResultsThere were 191 patients included in this study. Mean ages were 52.2 ± 11.8 years old and 51% were males. Total 143 (74.9%) patients had anemia, 111 (58.1%) had hypertension and 75 (39.3%) had type 2 diabetes mellitus. Mean serum creatinine was 10.5 ± 8.0 mg/dL. There were 176 (92.1%) patients with at least one form of ECG abnormalities. Prolonged QTc interval (36.6%), fragmented QRS complex (29.8%), poor R wave progression (24.6%), peaked T wave (22.0%) and left ventricular hypertrophy (16.7%) were the most common abnormalities.ConclusionsECG abnormalities are common among nondialysis late-stage CKD patients. Given the fact that long-term CKD influences the pathogenesis cardiovascular diseases and substantial cardiovascular mortality, there is a need to screen Indonesian CKD patients who are at risks of getting earlier complications.