Effects of the pre-existing coronary heart disease on the prognosis of COVID-19 patients: A systematic review and meta-analysis

Abstract

Although studies have shown severe Coronavirus disease 2019 (COVID-19) outcomes in patients with pre-existing coronary heart disease (CHD), the prognosis of COVID-19 patients with pre-existing CHD remains uncertain primarily due to the limited number of patients in existing studies. This study aimed to investigate the impacts of pre-existing CHD on the prognosis of COVID-19 patients. Five electronic databases were searched for eligible studies. This article focused on cohort and case-control studies involving the prognosis of COVID-19 patients with pre-existing CHD. The meta-analysis was performed using a random effects model. The odds ratios (ORs) and 95% confidence intervals (CIs) were used as valid indicators. The study was registered in PROSPERO with the identifier: CRD42022352853. A total of 81 studies, involving 157,439 COVID-19 patients, were included. The results showed that COVID-19 patients with pre-existing CHD exhibited an elevated risk of mortality (OR = 2.45; 95%CI: [2.04, 2.94], P < 0.001), severe/critical COVID-19 (OR = 2.57; 95%CI: [1.98, 3.33], P < 0.001), Intensive Care Unit or Coronary Care Unit (ICU/CCU) admission: (OR = 2.75, 95%CI: [1.61, 4.72], P = 0.002), and reduced odds of discharge/recovery (OR = 0.43, 95%CI: [0.28, 0.66], P < 0.001) compared to COVID-19 patients without pre-existing CHD. Subgroup analyses indicated that the prognosis of COVID-19 patients with pre-existing CHD was influenced by publication year, follow-up duration, gender, and hypertension. In conclusion, pre-existing CHD significantly increases the risk of poor prognosis in patients with COVID-19, particularly in those male or hypertensive patients.

Unraveling the Complex Interplay: COVID-19 and Heart Failure: A Comprehensive Review

“…Studies have shown that patients with pre-existing HF are at an elevated risk of excruciating ailment from COVID-19, with nearly one-third of such patients dying during hospitalization [43]. COVID-19 can exacerbate heart failure through several mechanisms, including inflammation, direct cardiac injury, and increased thrombotic activity [43][44][45][46]. A multicenter prospective study highlighted the role of NT-proBNP levels in predicting mortality in critically ill COVID-19 patients, with a 30-day mortality rate of 27.4% among the study participants [45].…”

“…A multicenter prospective study highlighted the role of NT-proBNP levels in predicting mortality in critically ill COVID-19 patients, with a 30-day mortality rate of 27.4% among the study participants [45]. Patients with a high probability of HF experienced a notably elevated mortality and morbidity rate in comparison to those with a lower likelihood (40.8% vs. 16.5%, respectively) [44]. A study conducted by Saikun Wang highlights the substantial impact of pre-existing coronary heart disease (CHD) on COVID-19 outcomes [45].…”

“…Healthcare providers must recognize the increased risks and manage these patients with careful consideration of their cardiac function and the potential impacts of COVID-19 on their cardiovascular health [45,46]. The prognosis and outcomes of HF and cardiovascular disease in COVID-19 patients have become significant areas of interest in recent research [44]. Recent studies have shed light on the prevalence and impact of cardiac arrhythmias in patients with COVID-19 infection [45][46][47][48].…”