Dataset Information

Prevalence and impact of cardiac injury on COVID-19: A systematic review and meta-analysis.

ABSTRACT:

Background

The exact prevalence and impact of cardiac injury in hospitalized patients with coronavirus disease 2019 (COVID-19) is still controversial. Hence, we aim to investigate prevalence of cardiac injury and its impact on the outcomes in patients with COVID-19.

Hypothesis

Cardiac injury is common and associated with higher risk of death.

Methods

We searched the Cochrane Library, PubMed, MedRxiv, and EMBASE databases from December 2019 to July 15, 2020 for studies that evaluated the prevalence and impact of cardiac injury on COVID-19. This study has been registered with PROSPERO (International prospective register of systematic reviews)-registration number-CRD-42020186120.

Results

Twenty-one studies including 6297 participants were identified. The proportions of cardiac injury were 22%, 28% among hospitalized patients with COVID-19 or severe COVID-19 patients, respectively. The incidences of cardiac injury in advance age (>60?years) (30%) was about two-fold than young patients (<60?years) (15%) with COVID-19. Severe cases (42%) have seven-fold prevalence cardiac injury than in their non- severe counterparts (6%). Furthermore, cardiac injury is associated with an increased risk of all-cause mortality in patients with COVID-19 (OR 10.11, 95% CI 4.49-22.77). In patients with severe COVID-19, cardiac injury is associated with an increased risk of all-cause mortality (OR: 16.79, 95% CI: 5.52-51.02).

Conclusions

This was the first meta-analysis exploring the prevalence and impact of cardiac injury on COVID-19. Cardiac injury is common in hospitalized patients and advanced age and severe COVID-19 patients prone to experience more risk of cardiac injury. Furthermore, cardiac injury is associated with increased risk of all-cause mortality.

SUBMITTER: Fu L

PROVIDER: S-EPMC7852167 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Prevalence and impact of cardiac injury on COVID-19: A systematic review and meta-analysis.

Fu Linghua L Liu Xiao X Su Yuhao Y Ma Jianyong J Hong Kui K

Clinical cardiology 20201231 2

<h4>Background</h4>The exact prevalence and impact of cardiac injury in hospitalized patients with coronavirus disease 2019 (COVID-19) is still controversial. Hence, we aim to investigate prevalence of cardiac injury and its impact on the outcomes in patients with COVID-19.<h4>Hypothesis</h4>Cardiac injury is common and associated with higher risk of death.<h4>Methods</h4>We searched the Cochrane Library, PubMed, MedRxiv, and EMBASE databases from December 2019 to July 15, 2020 for studies that ...[more]

PMID: 33382482

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Project description:Although most patients recover from COVID-19, it has been linked to cardiac, pulmonary, and neurologic complications. Despite not having formal criteria for its diagnosis, COVID-19 associated cardiomyopathy has been observed in several studies through biomarkers and imaging. This study aims to estimate the proportion of COVID-19 patients with cardiac abnormalities and to determine the association between the cardiac abnormalities in COVID-19 patients and disease severity and mortality. Observational studies published from December 1, 2019 to September 30, 2020 were obtained from electronic databases (PubMed, Embase, Cochrane Library, CNKI) and preprint servers (medRxiv, bioRxiv, ChinaXiv). Studies that have data on prevalence were included in the calculation of the pooled prevalence, while studies with comparison group were included in the calculation of the odds ratio. If multiple tests were done in the same study yielding different prevalence values, the largest one was used as the measure of prevalence of that particular study. Metafor using R software package version 4.0.2 was used for the meta-analysis. A total of 400 records were retrieved from database search, with 24 articles included in the final analysis. Pooled prevalence of cardiac abnormalities in 20 studies was calculated to be 0.31 [95% Confidence Intervals (CI) of (0.23; 0.41)], with statistically significant heterogeneity (percentage of variation or I-squared statistic I2 = 97%, p < 0.01). Pooled analysis of 19 studies showed an overall odds ratio (OR) of 6.87 [95%-CI (3.92; 12.05)] for cardiac abnormalities associated with disease severity and mortality, with statistically significant heterogeneity (I2 = 85%, between-study variance or tau-squared statistic τ2 = 1.1485, p < 0.01). Due to the high uncertainty in the pooled prevalence of cardiac abnormalities and the unquantifiable magnitude of risk (although an increased risk is certain) for severity or mortality among COVID-19 patients, much more long-term prognostic studies are needed to check for the long-term complications of COVID-19 and formalize definitive criteria of "COVID-19 associated cardiomyopathy".

Project description:Rationale & objectiveCoronavirus disease 2019 (COVID-19) may be associated with high rates of acute kidney injury (AKI) and kidney replacement therapy (KRT), potentially overwhelming health care resources. Our objective was to determine the pooled prevalence of AKI and KRT among hospitalized patients with COVID-19.Study designSystematic review and meta-analysis.Data sourcesMEDLINE, Embase, the Cochrane Library, and a registry of preprinted studies, published up to October 14, 2020.Study selectionEligible studies reported the prevalence of AKI in hospitalized patients with COVID-19 according to the Kidney Disease: Improving Global Outcomes (KDIGO) definition.Data extraction & synthesisWe extracted data on patient characteristics, the proportion of patients developing AKI and commencing KRT, important clinical outcomes (discharge from hospital, ongoing hospitalization, and death), and risk of bias.Outcomes & measuresWe calculated the pooled prevalence of AKI and receipt of KRT along with 95% CIs using a random-effects model. We performed subgroup analysis based on admission to an intensive care unit (ICU).ResultsOf 2,711 records reviewed, we included 53 published and 1 preprint study in the analysis, which comprised 30,657 hospitalized patients with COVID-19. Data for AKI were available for 30,639 patients (n = 54 studies), and receipt of KRT, for 27,525 patients (n = 48 studies). The pooled prevalence of AKI was 28% (95% CI, 22%-34%; I 2 = 99%), and the pooled prevalence of KRT was 9% (95% CI, 7%-11%; I 2 = 97%). The pooled prevalence of AKI among patients admitted to the ICU was 46% (95% CI, 35%-57%; I 2 = 99%), and 19% of all ICU patients with COVID-19 (95% CI, 15%-22%; I 2 = 88%) commenced KRT.LimitationsThere was significant heterogeneity among the included studies, which remained unaccounted for in subgroup analysis.ConclusionsAKI complicated the course of nearly 1 in 3 patients hospitalized with COVID-19. The risk for AKI was higher in critically ill patients, with a substantial number receiving KRT at rates higher than the general ICU population. Because COVID-19 will be a public health threat for the foreseeable future, these estimates should help guide KRT resource planning.

Dataset Information

Prevalence and impact of cardiac injury on COVID-19: A systematic review and meta-analysis.

Background

Hypothesis

Methods

Results

Conclusions

Publications

Prevalence and impact of cardiac injury on COVID-19: A systematic review and meta-analysis.

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