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Cardiol Rev . Significant Mortality Associated With COVID-19 and Comorbid Cerebrovascular Disease: A Quantitative Systematic Review

tetano

Editor, Senior Moderator
Cardiol Rev


. 2022 Dec 28.
doi: 10.1097/CRD.0000000000000480. Online ahead of print.
Significant Mortality Associated With COVID-19 and Comorbid Cerebrovascular Disease: A Quantitative Systematic Review


Tolga Sursal[SUP] 1 [/SUP], Chirag D Gandhi[SUP] 1 [/SUP], Kevin Clare[SUP] 2 [/SUP], Eric Feldstein[SUP] 1 [/SUP], Ilya Frid[SUP] 1 [/SUP], Martin Kefina[SUP] 1 [/SUP], Daniela Galluzzo[SUP] 1 [/SUP], Haris Kamal[SUP] 1 [/SUP], Rolla Nuoman[SUP] 1 [/SUP], Krishna Amuluru[SUP] 3 [/SUP], Carrie R Muh[SUP] 1 [/SUP], Jared M Pisapia[SUP] 1 [/SUP], Edwin Gulko[SUP] 1 [/SUP], Philip Overby[SUP] 1 [/SUP], Dipak Chandy[SUP] 1 [/SUP], Mill Etienne[SUP] 1 [/SUP], Christeena Kurian[SUP] 1 [/SUP], Gurmeen Kaur[SUP] 1 [/SUP], Katarina Dakay[SUP] 1 [/SUP], May AlHamid[SUP] 4 [/SUP], Hosam Al-Jehani[SUP] 4 [/SUP], Stephan A Mayer[SUP] 1 [/SUP], Fawaz Al-Mufti[SUP] 1 [/SUP]



Affiliations

Abstract

We report the first quantitative systematic review of cerebrovascular disease in coronavirus disease 2019 (COVID-19) to provide occurrence rates and associated mortality. Through a comprehensive search of PubMed we identified 8 cohort studies, 5 case series, and 2 case reports of acute cerebrovascular disease in patients with confirmed COVID-19 diagnosis. Our first meta-analysis utilizing the identified publications focused on comorbid cerebrovascular disease in recovered and deceased patients with COVID-19. We performed 3 additional meta-analyses of proportions to produce point estimates of the mortality and incidence of acute cerebrovascular disease in COVID-19 patients. Patient's with COVID-19 who died were 12.6 times more likely to have a history of cerebrovascular disease. We estimated an occurrence rate of 2.6% (95% confidence interval, 1.2-5.4%) for acute cerebrovascular disease among consecutively admitted patients with COVID-19. While for those with severe COVID-19' we estimated an occurrence rate of 6.5% (95% confidence interval, 4.4-9.6%). Our analysis estimated a rate of 35.5% for in-hospital mortality among COVID-19 patients with concomitant acute cerebrovascular disease. This was consistent with a mortality rate of 34.0% which we obtained through an individual patient analysis of 47 patients derived from all available case reports and case series. COVID-19 patients with either acute or chronic cerebrovascular disease have a high mortality rate with higher occurrence of cerebrovascular disease in patients with severe COVID-19.
 
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