INTRODUCTION: Coronavirus disease 2019 (COVID-19) has multiorgan involvement and its severity varies with the presence of pre-existing risk factors like cardiovascular disease (CVD) and hypertension (HTN). Therefore, it is important to evaluate their effect on outcomes of COVID-19 patients . The objective of this meta-analysis and meta-regression is to evaluate outcomes of COVID-19 amongst patients with CVD and HTN.
METHODS: English full-text observational studies having data on epidemiological characteristics of patients with COVID-19 were identified searching PubMed from December 1, 2019, to July 31, 2020, following Meta-analysis Of Observational Studies in Epidemiology (MOOSE) protocol . Studies having pre-existing CVD and HTN data that described outcomes including mortality and invasive mechanical ventilation (IMV) utilization were selected . Using random-effects models, risk of composite poor outcomes (meta-analysis) and isolated mortality and IMV utilization (meta-regression) were evaluated . Pooled prevalence of CVD and HTN, correlation coefficient (r) and odds ratio (OR) were estimated . The forest plots and correlation plots were created using random-effects models .
RESULTS: Out of 29 studies (n=27,950) that met the criteria , 28 and 27 studies had data on CVD and HTN, respectively . Pooled prevalence of CVD was 18.2% and HTN was 32.7% . In meta-analysis, CVD (OR : 3.36; 95% CI : 2.29-4.94) and HTN (OR : 1.94; 95% CI : 1.57-2.40) were associated with composite poor outcome . In age-adjusted meta-regression, pre-existing CVD was having significantly higher correlation of IMV utilization (r : 0.28; OR : 1.3; 95% CI : 1.1-1.6) without having any association with mortality (r: -0.01; OR : 0.9; 95% CI : 0.9-1.1) among COVID-19 hospitalizations . HTN was neither correlated with higher IMV utilization (r : 0.01; OR : 1.0; 95% CI : 0.9-1.1) nor correlated with higher mortality (r : 0.001; OR : 1.0; 95% CI : 0.9-1.1).
CONCLUSION: In age-adjusted analysis, though we identified pre-existing CVD as a risk factor for higher utilization of mechanical ventilation, pre-existing CVD and HTN had no independent role in increasing mortality.
Index: 2019-ncov, atrial fibrillation, cardiovascular disease, coronavirus disease 2019 (covid-19), hypertension, invasive mechanical ventilation, novel coronavirus disease 2019, risk factors, sars-cov-2, systematic review and meta-analysis