Impact of cardiovascular diseases on severity of COVID-19 patients: A systematic review

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) cases are increasing rapidly worldwide. Similar to Middle East respiratory syndrome where cardiovascular diseases were present in nearly 30% of cases, the increased presence of cardiovascular comorbidities remains true for COVID-19 as well. The mechanism of this association remains unclear at this time. Therefore, we reviewed the available literature and tried to find the probable association between cardiovascular disease with disease severity and mortality in COVID-19 patients. Methods: We searched Medline (via PubMed) and Cochrane Central Register of Controlled Trials for articles published until Sept 5, 2020. Nineteen articles were included involving 6,872 COVID-19 patients. Results: The random-effect meta-analysis showed that cardiovascular disease was significantly associated with severity and mortality for COVID-19: odds ratio (OR) 2.89, 95% confidence interval (CI) 1.98–4.21 for severity and OR 3.00, 95% CI 1.67–5.39 for mortality, respectively. Risk of COVID-19 severity was higher in patients having diabetes, hypertension, chronic obstructive pulmonary disease, malignancy, cerebrovascular disease and chronic kidney disease. Similarly, patients with diabetes, hypertension, chronic liver disease, cerebrovascular disease and chronic kidney disease were at higher risk of mortality. Conclusion: Our findings showed that cardiovascular disease has a negative effect on health status of COVID-19 patients. However, large prevalence studies demonstrating the consequences of comorbid cardiovascular disease are urgently needed to understand the extent of these concerning comorbidities. Keywords: Cardiovascular disease, COVID-19, SARS-CoV-2

Heterogeneity and Risk of Bias in Studies Examining Risk Factors for Severe Illness and Death in COVID-19: A Systematic Review and Meta-Analysis

“…This systematic review and its meta-analyses confirm several correlations between demographic factors and comorbidities and severe illness and death among COVID-19 patients that have been reported in other reviews [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. COVID-19 patients who were smokers, males, with ages ≥60 or 65 years, and those who had hypertension, diabetes, cardiovascular disease, cancer, chronic respiratory disease, chronic kidney disease, chronic liver disease, and cerebrovascular diseases were found to be more susceptible to death.…”

“…This systematic review has several strengths. Unlike previous meta-analyses on related topics [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ], this study: (i) involves a comprehensive analysis of a large number of studies that are based in different countries in the world; (ii) includes many articles that were published in 2021, after the introduction of the Delta strain; (iii) analyzes only peer-reviewed data; (iv) assesses the extensive analysis of the source of the heterogeneity and bias in the studies; and (v) compares the risk of admission to the ICU vs. no admission among hospitalized COVID-19 patients, and is stratified on the basis of comorbidities and demographic status.…”

“…The disease outcomes from SARS-CoV-2 infection may vary, which is due to a range of health and demographic factors [ 2 , 3 , 4 ]. Indeed, several meta-analyses studies have correlated hypertension, cardiovascular disease, an older age, and the male sex with severe illness and mortality in COVID-19 patients [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. However, the associations with other comorbidities have been less clear, such as with cancer, chronic liver disease, diabetes, and kidney disease.…”

Acute Coronary Syndrome in the COVID-19 Era—Differences and Dilemmas Compared to the Pre-COVID-19 Era

“…Significantly higher mortality was registered in the group of patients with CVD than in the group of patients without CVD [ 8 ]. That CVD is significantly associated with a more severe clinical picture and poorer outcome in patients with COVID-19 was also confirmed by the results of a meta-analysis by Mishra P. et al (OR 2.89; 95% CI 1.98–4.21 for severity and OR 3.00, 95% CI 1.67–5.39 for mortality, respectively) [ 10 ].…”

Fractional order modelling of omicron SARS-CoV-2 variant containing heart attack effect using real data from the United Kingdom

“…Impact of COVID-19 on cardiovascular complications and increased mortality in patients with recent cardiovascular disease (CVD) mentioned in many medical studies [28] , [29] , [30] . The virus invades heart muscle cells by binding to angiotensin-converting enzyme 2 cell surface, resulting in myocardial injury and elevation of troponin I levels.…”