tetano
Editor, Senior Moderator
BMC Cardiovasc Disord
. 2021 Jan 7;21(1):23.
doi: 10.1186/s12872-020-01816-3.
Cardiovascular risk factors and mortality in hospitalized patients with COVID-19: systematic review and meta-analysis of 45 studies and 18,300 patients
Angelo Silverio[SUP] 1 [/SUP], Marco Di Maio[SUP] 1 [/SUP], Rodolfo Citro[SUP] 2 [/SUP], Luca Esposito[SUP] 2 [/SUP], Giuseppe Iuliano[SUP] 2 [/SUP], Michele Bellino[SUP] 2 [/SUP], Cesare Baldi[SUP] 2 [/SUP], Giuseppe De Luca[SUP] 3 [/SUP], Michele Ciccarelli[SUP] 1 [/SUP], Carmine Vecchione[SUP] 1 4 [/SUP], Gennaro Galasso[SUP] 5 [/SUP]
Affiliations
Abstract
Background: A high prevalence of cardiovascular risk factors including age, male sex, hypertension, diabetes, and tobacco use, has been reported in patients with Coronavirus disease 2019 (COVID-19) who experienced adverse outcome. The aim of this study was to investigate the relationship between cardiovascular risk factors and in-hospital mortality in patients with COVID-19.
Methods: MEDLINE, Cochrane, Web of Sciences, and SCOPUS were searched for retrospective or prospective observational studies reporting data on cardiovascular risk factors and in-hospital mortality in patients with COVID-19. Univariable and multivariable age-adjusted analyses were conducted to evaluate the association between cardiovascular risk factors and the occurrence of in-hospital death.
Results: The analysis included 45 studies enrolling 18,300 patients. The pooled estimate of in-hospital mortality was 12% (95% CI 9-15%). The univariable meta-regression analysis showed a significant association between age (coefficient: 1.06; 95% CI 1.04-1.09; p < 0.001), diabetes (coefficient: 1.04; 95% CI 1.02-1.07; p < 0.001) and hypertension (coefficient: 1.01; 95% CI 1.01-1.03; p = 0.013) with in-hospital death. Male sex and smoking did not significantly affect mortality. At multivariable age-adjusted meta-regression analysis, diabetes was significantly associated with in-hospital mortality (coefficient: 1.02; 95% CI 1.01-1.05; p = 0.043); conversely, hypertension was no longer significant after adjustment for age (coefficient: 1.00; 95% CI 0.99-1.01; p = 0.820). A significant association between age and in-hospital mortality was confirmed in all multivariable models.
Conclusions: This meta-analysis suggests that older age and diabetes are associated with higher risk of in-hospital mortality in patients infected by SARS-CoV-2. Conversely, male sex, hypertension, and smoking did not independently correlate with fatal outcome.
Keywords: COVID-19; Cardiovascular risk factors; Diabetes; Hypertension; Mortality; Novel coronavirus; Outcome; SARS-CoV-2; Smoking.
. 2021 Jan 7;21(1):23.
doi: 10.1186/s12872-020-01816-3.
Cardiovascular risk factors and mortality in hospitalized patients with COVID-19: systematic review and meta-analysis of 45 studies and 18,300 patients
Angelo Silverio[SUP] 1 [/SUP], Marco Di Maio[SUP] 1 [/SUP], Rodolfo Citro[SUP] 2 [/SUP], Luca Esposito[SUP] 2 [/SUP], Giuseppe Iuliano[SUP] 2 [/SUP], Michele Bellino[SUP] 2 [/SUP], Cesare Baldi[SUP] 2 [/SUP], Giuseppe De Luca[SUP] 3 [/SUP], Michele Ciccarelli[SUP] 1 [/SUP], Carmine Vecchione[SUP] 1 4 [/SUP], Gennaro Galasso[SUP] 5 [/SUP]
Affiliations
- PMID: 33413093
- DOI: 10.1186/s12872-020-01816-3
Abstract
Background: A high prevalence of cardiovascular risk factors including age, male sex, hypertension, diabetes, and tobacco use, has been reported in patients with Coronavirus disease 2019 (COVID-19) who experienced adverse outcome. The aim of this study was to investigate the relationship between cardiovascular risk factors and in-hospital mortality in patients with COVID-19.
Methods: MEDLINE, Cochrane, Web of Sciences, and SCOPUS were searched for retrospective or prospective observational studies reporting data on cardiovascular risk factors and in-hospital mortality in patients with COVID-19. Univariable and multivariable age-adjusted analyses were conducted to evaluate the association between cardiovascular risk factors and the occurrence of in-hospital death.
Results: The analysis included 45 studies enrolling 18,300 patients. The pooled estimate of in-hospital mortality was 12% (95% CI 9-15%). The univariable meta-regression analysis showed a significant association between age (coefficient: 1.06; 95% CI 1.04-1.09; p < 0.001), diabetes (coefficient: 1.04; 95% CI 1.02-1.07; p < 0.001) and hypertension (coefficient: 1.01; 95% CI 1.01-1.03; p = 0.013) with in-hospital death. Male sex and smoking did not significantly affect mortality. At multivariable age-adjusted meta-regression analysis, diabetes was significantly associated with in-hospital mortality (coefficient: 1.02; 95% CI 1.01-1.05; p = 0.043); conversely, hypertension was no longer significant after adjustment for age (coefficient: 1.00; 95% CI 0.99-1.01; p = 0.820). A significant association between age and in-hospital mortality was confirmed in all multivariable models.
Conclusions: This meta-analysis suggests that older age and diabetes are associated with higher risk of in-hospital mortality in patients infected by SARS-CoV-2. Conversely, male sex, hypertension, and smoking did not independently correlate with fatal outcome.
Keywords: COVID-19; Cardiovascular risk factors; Diabetes; Hypertension; Mortality; Novel coronavirus; Outcome; SARS-CoV-2; Smoking.