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Impact of cardiovascular disease on clinical outcomes in hospitalized patients with Covid-19: a systematic review and meta-analysis
Contrasting data have been published about the impact of cardiovascular disease on Covid-19. A comprehensive synthesis and pooled analysis of the available evidence is needed to guide prioritization of prevention strategies. To clarify the association of cardiovascular disease with Covid-19 outcomes...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8285708/ https://www.ncbi.nlm.nih.gov/pubmed/34273056 http://dx.doi.org/10.1007/s11739-021-02804-x |
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author | Maddaloni, Ernesto D’Onofrio, Luca Siena, Antonio Luordi, Cecilia Mignogna, Carmen Amendolara, Rocco Cavallari, Ilaria Grigioni, Francesco Buzzetti, Raffaella |
author_facet | Maddaloni, Ernesto D’Onofrio, Luca Siena, Antonio Luordi, Cecilia Mignogna, Carmen Amendolara, Rocco Cavallari, Ilaria Grigioni, Francesco Buzzetti, Raffaella |
author_sort | Maddaloni, Ernesto |
collection | PubMed |
description | Contrasting data have been published about the impact of cardiovascular disease on Covid-19. A comprehensive synthesis and pooled analysis of the available evidence is needed to guide prioritization of prevention strategies. To clarify the association of cardiovascular disease with Covid-19 outcomes, we searched PubMed up to 26 October 2020, for studies reporting the prevalence of cardiovascular disease among inpatients with Covid-19 in relation to their outcomes. Pooled odds-ratios (OR) for death, for mechanical ventilation or admission in an intensive care unit (ICU) and for composite outcomes were calculated using random effect models overall and in the subgroup of people with comorbid diabetes. Thirty-three studies enrolling 52,857 inpatients were included. Cardiovascular disease was associated with a higher risk of death both overall (OR 2.58, 95% confidence intervals, CI 2.12–3.14, p < 0.001, number of studies 24) and in the subgroup of people with diabetes (OR 2.91, 95% CI 2.13–3.97, p < 0.001, number of studies 4), but not with higher risk of ICU admission or mechanical ventilation (OR 1.35, 95% CI 0.73–2.50, p = 0.34, number of studies 4). Four out of five studies reporting OR adjusted for confounders failed to show independent association of cardiovascular disease with Covid-19 deaths. Accordingly, the adjusted-OR for Covid-19 death in people with cardiovascular disease dropped to 1.31 (95% CI 1.01–1.70, p = 0.041). Among patients hospitalized for Covid-19, cardiovascular disease confers higher risk of death, which was highly mitigated when adjusting the association for confounders. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11739-021-02804-x. |
format | Online Article Text |
id | pubmed-8285708 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-82857082021-07-19 Impact of cardiovascular disease on clinical outcomes in hospitalized patients with Covid-19: a systematic review and meta-analysis Maddaloni, Ernesto D’Onofrio, Luca Siena, Antonio Luordi, Cecilia Mignogna, Carmen Amendolara, Rocco Cavallari, Ilaria Grigioni, Francesco Buzzetti, Raffaella Intern Emerg Med CE-Systematic reviews and meta-analysis Contrasting data have been published about the impact of cardiovascular disease on Covid-19. A comprehensive synthesis and pooled analysis of the available evidence is needed to guide prioritization of prevention strategies. To clarify the association of cardiovascular disease with Covid-19 outcomes, we searched PubMed up to 26 October 2020, for studies reporting the prevalence of cardiovascular disease among inpatients with Covid-19 in relation to their outcomes. Pooled odds-ratios (OR) for death, for mechanical ventilation or admission in an intensive care unit (ICU) and for composite outcomes were calculated using random effect models overall and in the subgroup of people with comorbid diabetes. Thirty-three studies enrolling 52,857 inpatients were included. Cardiovascular disease was associated with a higher risk of death both overall (OR 2.58, 95% confidence intervals, CI 2.12–3.14, p < 0.001, number of studies 24) and in the subgroup of people with diabetes (OR 2.91, 95% CI 2.13–3.97, p < 0.001, number of studies 4), but not with higher risk of ICU admission or mechanical ventilation (OR 1.35, 95% CI 0.73–2.50, p = 0.34, number of studies 4). Four out of five studies reporting OR adjusted for confounders failed to show independent association of cardiovascular disease with Covid-19 deaths. Accordingly, the adjusted-OR for Covid-19 death in people with cardiovascular disease dropped to 1.31 (95% CI 1.01–1.70, p = 0.041). Among patients hospitalized for Covid-19, cardiovascular disease confers higher risk of death, which was highly mitigated when adjusting the association for confounders. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11739-021-02804-x. Springer International Publishing 2021-07-17 2021 /pmc/articles/PMC8285708/ /pubmed/34273056 http://dx.doi.org/10.1007/s11739-021-02804-x Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | CE-Systematic reviews and meta-analysis Maddaloni, Ernesto D’Onofrio, Luca Siena, Antonio Luordi, Cecilia Mignogna, Carmen Amendolara, Rocco Cavallari, Ilaria Grigioni, Francesco Buzzetti, Raffaella Impact of cardiovascular disease on clinical outcomes in hospitalized patients with Covid-19: a systematic review and meta-analysis |
title | Impact of cardiovascular disease on clinical outcomes in hospitalized patients with Covid-19: a systematic review and meta-analysis |
title_full | Impact of cardiovascular disease on clinical outcomes in hospitalized patients with Covid-19: a systematic review and meta-analysis |
title_fullStr | Impact of cardiovascular disease on clinical outcomes in hospitalized patients with Covid-19: a systematic review and meta-analysis |
title_full_unstemmed | Impact of cardiovascular disease on clinical outcomes in hospitalized patients with Covid-19: a systematic review and meta-analysis |
title_short | Impact of cardiovascular disease on clinical outcomes in hospitalized patients with Covid-19: a systematic review and meta-analysis |
title_sort | impact of cardiovascular disease on clinical outcomes in hospitalized patients with covid-19: a systematic review and meta-analysis |
topic | CE-Systematic reviews and meta-analysis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8285708/ https://www.ncbi.nlm.nih.gov/pubmed/34273056 http://dx.doi.org/10.1007/s11739-021-02804-x |
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