Preexisting coronary artery disease among coronavirus disease 2019 patients: a systematic review and meta-analysis

Abstract

Aims The prevalence and prognostic implications of coronary artery disease (CAD) in patients infected by the novel coronavirus 2019 (COVID-19) disease remain unclear.Methods We conducted a systematic review and metaanalysis to investigate the prevalence and mortality risk in COVID-19 patients with preexisting CAD. We searched Medline and Scopus to locate all articles published up to December 8, 2021, reporting data of COVID-19 survivors and nonsurvivors with preexisting CAD. Data were pooled using the Mantel-Haenszel random effects models with odds ratio (OR) as the effect measure with the related 95% confidence interval (CI).Results Thirty-eight studies including 27 435 patients (mean age 61.5 and 70.9 years) were analysed. The pooled prevalence of preexisting CAD was 12.6% (95% CI: 11.2-16.5%, I 2 : 95.6%), and resulted as higher in intensive care unit patients (17.5%, 95% CI: 11.9-25.1, I 2 : 88.4%) and in European cohorts (13.1%, 95% CI: 7.8-21.6%, P < 0.001, I 2 : 98.4%). COVID-19 patients with preexisting CAD had a twofold risk of short-term mortality (OR 2.61, 95% CI 2.10-3.24, P < 0.001, I 2 U 73.6%); this risk was higher among Asian cohorts (OR: 2.66, 95% CI: 1.79-3.90, P < 0.001, I 2 : 77.3%) compared with European (OR: 2.44, 95% CI: 1.90-3.14, P < 0.001, I 2 : 56.9%) and American (OR: 1.86, 95% CI: 1.41-2.44, P < 0.001, I 2 : 0%) populations. The association between CAD and poor short-term prognosis was influenced by age, prevalence of hypertension (HT), DM and CKD.Conclusions Preexisting CAD is present in approximately 1 in 10 patients hospitalized for COVID-19 and significantly associated with an increased risk of short-term mortality, which is influenced by age, HT, DM and CKD.

Beneficial effects of prehospital use of statins in a large United States cohort of hospitalized coronavirus disease 2019 patients

“…To note, a few studies do not support the protective role of statins and have shown an association between chronic use of statins with higher mortality and/or morbidity; 29–31 in particular, patients with type 2 diabetes showed the worst outcomes 29,30 . Our study does not support these findings despite the preexisting statin users in the propensity matching score analysis having a higher incidence of diabetes than the statin nonusers (60.1 vs. 56.8%; P -value <0.001).…”

COVID-19 and Clostridioides difficile Coinfection Analysis in the Intensive Care Unit

“…Chronic liver disease is known as an independent risk factor for CDI infection, as well as for COVID-19 infection, due to frequent hospitalizations and reduced immunity [16,42]. It has also been noted that patients with concurrent COVID-19 and CDI have a higher prevalence of essential hypertension (HTN), coronary artery disease (CAD), and congestive heart failure (CHF) [43]. A metaanalysis showed that pre-existing coronary artery disease (CAD) is present in about onetenth of hospitalized patients with COVID-19 [44].…”

COVID-19 and Clostridioides difficile Coinfection Outcomes among Hospitalized Patients in the United States: An Insight from National Inpatient Database

“…Patients with COVID-19 and concomitant CDI were also observed to have a higher prevalence of essential hypertension (HTN), coronary artery disease (CAD) and congestive heart failure (CHF). A meta-analysis showed that preexisting CAD is roughly present in a tenth of patients hospitalized for COVID-19 [ 11 ]. Similarly, CHF and CAD are overall associated with an increased mortality during active COVID-19 infection [ 12 , 13 ].…”