Cardiovascular risk factors and mortality in hospitalized patients with COVID-19: systematic review and meta-analysis of 45 studies and 18,300 patients.
Age Factors
Analysis of Variance
COVID-19
/ mortality
Cardiovascular Diseases
/ etiology
Diabetes Mellitus
/ mortality
Female
Hospital Mortality
Humans
Hypertension
/ mortality
Male
Observational Studies as Topic
Publication Bias
Regression Analysis
Risk Factors
SARS-CoV-2
Sex Factors
Smoking
/ mortality
COVID-19
Cardiovascular risk factors
Diabetes
Hypertension
Mortality
Novel coronavirus
Outcome
SARS-CoV-2
Smoking
Journal
BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539
Informations de publication
Date de publication:
07 01 2021
07 01 2021
Historique:
received:
28
07
2020
accepted:
08
12
2020
entrez:
8
1
2021
pubmed:
9
1
2021
medline:
14
1
2021
Statut:
epublish
Résumé
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. 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. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 33413093
doi: 10.1186/s12872-020-01816-3
pii: 10.1186/s12872-020-01816-3
pmc: PMC7789083
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
23Commentaires et corrections
Type : CommentIn
Références
J Infect. 2020 Jul;81(1):e6-e12
pubmed: 32283162
Emerg Infect Dis. 2020 Jun;26(6):1251-1256
pubmed: 32168464
JAMA Cardiol. 2020 Jul 1;5(7):811-818
pubmed: 32219356
Lancet Glob Health. 2020 Apr;8(4):e480
pubmed: 32109372
Gut. 2020 Jun;69(6):1002-1009
pubmed: 32213556
JAMA. 2020 Apr 28;323(16):1559-1560
pubmed: 32250408
MMWR Morb Mortal Wkly Rep. 2020 Apr 03;69(13):382-386
pubmed: 32240123
JAMA. 2020 May 12;323(18):1775-1776
pubmed: 32203977
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
Allergy. 2020 Jul;75(7):1809-1812
pubmed: 32281110
J Infect. 2020 Jun;80(6):639-645
pubmed: 32240670
Lancet. 2020 Feb 15;395(10223):507-513
pubmed: 32007143
J Clin Invest. 2020 May 1;130(5):2620-2629
pubmed: 32217835
Eur Heart J. 2020 Nov 1;41(41):3973-3975
pubmed: 32255477
JAMA. 2020 Apr 28;323(16):1574-1581
pubmed: 32250385
Allergy. 2020 Jul;75(7):1742-1752
pubmed: 32239761
J Clin Epidemiol. 2001 May;54(5):440-7
pubmed: 11337206
N Engl J Med. 2020 Feb 20;382(8):727-733
pubmed: 31978945
Diabetes Metab Res Rev. 2020 Mar 31;:e3319
pubmed: 32233013
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
J Thromb Haemost. 2020 Jun;18(6):1421-1424
pubmed: 32271988
Infect Control Hosp Epidemiol. 2020 Aug;41(8):982-983
pubmed: 32279676
Anaesth Crit Care Pain Med. 2020 Oct;39(5):553-561
pubmed: 32278670
Clin Infect Dis. 2020 Jul 28;71(15):769-777
pubmed: 32176772
JAMA. 2020 May 26;323(20):2052-2059
pubmed: 32320003
JAMA. 2020 Apr 28;323(16):1612-1614
pubmed: 32191259
J Med Virol. 2020 Jul;92(7):856-862
pubmed: 32281668
J Thromb Haemost. 2020 Jun;18(6):1324-1329
pubmed: 32306492
Am J Respir Crit Care Med. 2020 Jun 1;201(11):1380-1388
pubmed: 32275452
Med J Aust. 2020 May;212(9):416-420
pubmed: 32266987
Lancet Infect Dis. 2020 Apr;20(4):425-434
pubmed: 32105637
J Infect. 2020 Jul;81(1):e51-e60
pubmed: 32315725
N Engl J Med. 2020 Jun 11;382(24):2372-2374
pubmed: 32302078
Kidney Int. 2020 May;97(5):829-838
pubmed: 32247631
N Engl J Med. 2020 May 21;382(21):2005-2011
pubmed: 32220208
Clin Transl Sci. 2020 Nov;13(6):1077-1086
pubmed: 32315487
Nature. 2020 Aug;584(7821):430-436
pubmed: 32640463
PLoS One. 2020 Mar 19;15(3):e0230548
pubmed: 32191764
Nature. 2005 Jul 7;436(7047):112-6
pubmed: 16001071
JAMA Cardiol. 2020 Jul 1;5(7):825-830
pubmed: 32324209
Chin Med J (Engl). 2020 May 5;133(9):1032-1038
pubmed: 32118640
JAMA Cardiol. 2020 Jul 1;5(7):802-810
pubmed: 32211816
BMJ. 2020 Mar 26;368:m1091
pubmed: 32217556
N Engl J Med. 2020 Jun 25;382(26):2582
pubmed: 32501665
J Clin Virol. 2020 Jun;127:104363
pubmed: 32298988
Int J Epidemiol. 2011 Oct;40(5):1292-307
pubmed: 21737403
JAMA. 2000 Apr 19;283(15):2008-12
pubmed: 10789670
Obesity (Silver Spring). 2020 Jul;28(7):1195-1199
pubmed: 32271993
Eur Respir J. 2020 May 14;55(5):
pubmed: 32217650
Ther Adv Chronic Dis. 2020 Jun 25;11:2040622320935765
pubmed: 32637059
J Thromb Haemost. 2020 May;18(5):1094-1099
pubmed: 32220112
JAMA Intern Med. 2020 Jul 1;180(7):934-943
pubmed: 32167524
PLoS One. 2020 Aug 14;15(8):e0237131
pubmed: 32797054
J Infect. 2020 Jun;80(6):e14-e18
pubmed: 32171866
N Engl J Med. 2020 Jun 11;382(24):2327-2336
pubmed: 32275812
N Engl J Med. 2020 May 21;382(21):2012-2022
pubmed: 32227758
J Med Virol. 2020 Sep;92(9):1596-1602
pubmed: 32249943
JAMA. 2020 Jun 2;323(21):2195-2198
pubmed: 32329797
Circulation. 2016 Jun 7;133(23):2314-33
pubmed: 27267538
Circ Res. 2020 Jun 5;126(12):1671-1681
pubmed: 32302265
Nat Rev Cardiol. 2020 May;17(5):259-260
pubmed: 32139904
Eur Respir J. 2020 May 7;55(5):
pubmed: 32269088
J Am Heart Assoc. 2019 Jun 18;8(12):e012356
pubmed: 31166153
Chin Med J (Engl). 2020 May 5;133(9):1025-1031
pubmed: 32044814
BMJ. 2003 Sep 6;327(7414):557-60
pubmed: 12958120