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    Findings on the relationship between cardiovascular disease MESHD and coronavirus disease MESHD 2019: a systematic review

    Authors: Yuri Henrique da Silva1; José Gildo de Moura Monteiro Júnior; Rosângela Ferreira Frade de Araújo

    doi:10.21203/rs.3.rs-84991/v1 Date: 2020-09-28 Source: ResearchSquare

    Coronavirus disease 2019 (COVID-19) presents as the main cause of death MESHD, respiratory and heart failures MESHD, especially in the elderly TRANS, immunosuppressed, and those with cardiovascular comorbidities. Therefore, a better understanding of these findings is needed. A systematic review was carried out looking for articles published between December 2019 and May 2020 on the MEDLINE / PubMed search platform using the following descriptors: (((((((((" cardiovascular disease MESHD") OR ("acute myocardial infarction HP myocardial infarction MESHD")) OR (" coronary artery disease MESHD")) OR ("acute coronary syndrome MESHD")) OR (" atherosclerosis HP atherosclerosis MESHD")) OR (" cardiac insufficiency MESHD")) OR (" pericarditis HP pericarditis MESHD")) OR (" myocarditis HP myocarditis MESHD")) AND ("COVID-19")) OR ("SARS-CoV-2")and considering inclusion and exclusion criteria.40% of patients infected with SARS-CoV-2 had hypertension HP hypertension MESHD or other cardiovascular comorbidities, while 27% presented cardiovascular complications, mainly acute cardiac injury MESHD, arrhythmia HP arrhythmia MESHD and heart failure MESHD. The hypotheses of involvement of an intense inflammatory response, decreased HP immunity and greater expression of ACE2 in the heart, associated with more severe heart conditions, were discussed in this study. The increase in cardiac and inflammatory markers was associated with worse clinical outcomes and risk of death MESHD, confirming the need to evaluate them since admission to the hospital. The 10 articles analyzed presented as a limitation the small number of patients inserted, to the detriment of the pandemic state. We warned about the need for better clinical management of patients with cardiovascular comorbidities MESHD, and the importance of including this group among the first to be immunized, aiming at reducing the number of fatal cases due to infection MESHD. Studies with greater coverage are needed for a better comprehension of the topics discussed here.

    Impact of Congestive Heart Failure HP Congestive Heart Failure MESHD and Role of Cardiac Biomarkers in COVID-19 patients: A Systematic Review and Meta-Analysis

    Authors: Tarun Dalia; Shubham Lahan; Sagar Ranka; Prakash Acharya; Archana Gautam; Ioannis Mastoris; Andrew Sauer; Zubair Shah

    doi:10.1101/2020.07.06.20147421 Date: 2020-07-07 Source: medRxiv

    Background: Coronavirus disease 2019 (COVID-19) has been reported to cause worse outcomes in patients with underlying cardiovascular disease MESHD, especially in patients with acute cardiac injury MESHD, which is determined by elevated levels of high- sensitivity SERO troponin. There is a paucity of data on the impact of congestive heart failure HP congestive heart failure MESHD ( CHF MESHD) on outcomes in COVID-19 patients. Methods: We conducted a literature search of PubMed/Medline, EMBASE, and Google Scholar databases from 11/1/2019 till 06/07/2020, and identified all relevant studies reporting cardiovascular comorbidities, cardiac biomarkers, disease severity, and survival. Pooled data from the selected studies were used for metanalysis to identify the impact of risk factors and cardiac biomarker elevation on disease severity and/or mortality. Results: We collected pooled data on 5,967 COVID-19 patients from 20 individual studies. We found that both non-survivors and those with severe disease had an increased risk of acute cardiac injury MESHD and cardiac arrhythmias MESHD arrhythmias HP, our pooled relative risk (RR) was - 8.52 (95% CI 3.63-19.98) (p<0.001); and 3.61 (95% CI 2.03-6.43) (p=0.001), respectively. Mean difference in the levels of Troponin-I, CK-MB, and NT-proBNP was higher in deceased and severely infected MESHD patients. The RR of in-hospital mortality was 2.35 (95% CI 1.18-4.70) (p=0.022) and 1.52 (95% CI 1.12-2.05) (p=0.008) among patients who had pre-existing CHF MESHD and hypertension HP hypertension MESHD, respectively. Conclusion: Cardiac involvement in COVID-19 infection MESHD appears to significantly adversely impact patient prognosis and survival. Pre-existence of CHF MESHD and high cardiac biomarkers like NT-pro BNP and CK-MB levels in COVID-19 patients correlates with worse outcomes. Keywords: Acute cardiac injury MESHD; cardiac arrhythmia MESHD arrhythmia HP; mortality risk; cardiac biomarkers, COVID-19.

    The association of cardiovascular disease MESHD and other pre-existing comorbidities with COVID-19 mortality: A systematic review and meta-analysis

    Authors: Paddy Ssentongo; Anna E. Ssentongo; Emily S. Heilbrunn; Djibril M Ba; Vernon M. Chinchilli

    doi:10.1101/2020.05.10.20097253 Date: 2020-05-14 Source: medRxiv

    Background Exploring the association of coronavirus-2019 disease (COVID-19) mortality with chronic pre-existing conditions may promote the importance of targeting these populations during this pandemic to optimize survival. The objective of this systematic review and meta-analysis is to explore the association of pre-existing conditions with COVID-19 mortality. Methods We searched MEDLINE, OVID databases, SCOPUS, and medrxiv.org for the period December 1, 2019, to May 1, 2020. The outcome of interest was the risk of COVID-19 mortality in patients with and without pre-existing conditions. Comorbidities explored were cardiovascular diseases MESHD ( coronary artery disease MESHD, hypertension HP hypertension MESHD, cardiac arrhythmias MESHD arrhythmias HP, and congestive heart failure HP congestive heart failure MESHD), chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD, type 2 diabetes MESHD, cancer MESHD, chronic kidney disease HP chronic kidney disease MESHD, chronic liver disease MESHD, and stroke HP stroke MESHD. Two independent reviewers extracted data and assessed the risk of bias. All analyses were performed using random-effects models and heterogeneity was quantified. Results Ten chronic conditions from 19 studies were included in the meta-analysis (n = 61,455 patients with COVID-19; mean age TRANS, 61 years; 57% male TRANS). Overall the between-study study heterogeneity was medium and studies had low publication bias MESHD and high quality. Coronary heart disease MESHD, hypertension HP hypertension MESHD, congestive heart failure HP congestive heart failure MESHD, and cancer MESHD significantly increased the risk of mortality from COVID-19. The risk of mortality from COVID-19 in patients with coronary heart disease MESHD was 2.4 times as high as those without coronary heart disease MESHD (RR= 2.40, 95%CI=1.71-3.37, n=5) and twice as high in patients with hypertension HP hypertension MESHD as high as that compared to those without hypertension HP hypertension MESHD (RR=1.89, 95%CI= 1.58-2.27, n=9). Patients with cancer MESHD also were at twice the risk of mortality from COVID-19 compared to those without cancer MESHD (RR=1.93 95%CI 1.15-3.24, n=4), and those with congestive heart failure HP congestive heart failure MESHD were at 2.5 times the risk of mortality compared to those without congestive heart failure HP congestive heart failure MESHD (RR=2.66, 95%CI 1.58-4.48, n=3). Conclusions COVID-19 patients with all any cardiovascular disease MESHD, coronary heart disease MESHD, hypertension HP hypertension MESHD, congestive heart failure HP congestive heart failure MESHD, and cancer MESHD have an increased risk of mortality. Tailored infection MESHD prevention and treatment strategies targeting this high-risk population are warranted to optimize survival.

    Cardiovascular Diseases MESHD and COVID-19 Mortality and Intensive Care Unit Admission: A Systematic Review and Meta-analysis

    Authors: Amirhossein Hessami; Amir Shamshirian; Keyvan Heydari; Fatemeh Pourali; Reza Alizadeh-Navaei; Mahmood Moosazadeh; Saeed Abrotan; Layla Shojaei; Sogol Sedighi; Danial Shamshirian; Nima Rezaei

    doi:10.1101/2020.04.12.20062869 Date: 2020-04-16 Source: medRxiv

    Background: High rate of cardiovascular disease MESHD ( CVD MESHD) have been reported among patients with novel coronavirus disease MESHD (COVID-19). Meanwhile there were controversies among different studies about CVD MESHD burden in COVID-19 patients. Hence, we aimed to study CVD MESHD burden among COVID-19 patients, using a systematic review and meta-analysis. Methods: We have systematically searched databases including PubMed, Embase, Cochrane Library, Scopus, Web of Science as well as medRxiv pre-print database. Hand searched was also conducted in journal websites and Google Scholar. Meta-analyses were carried out for Odds Ratio (OR) of mortality and Intensive Care Unit (ICU) admission for different CVDs. We have also performed a descriptive meta-analysis on different CVDs. Results: Fifty-six studies entered into meta-analysis for ICU admission and mortality outcome and 198 papers for descriptive outcomes, including 159,698 COVID-19 patients. Results of meta-analysis indicated that acute cardiac injury MESHD, (OR: 13.29, 95% CI 7.35-24.03), hypertension HP hypertension MESHD (OR: 2.60, 95% CI 2.11-3.19), heart Failure MESHD (OR: 6.72, 95% CI 3.34-13.52), arrhythmia HP arrhythmia MESHD (OR: 2.75, 95% CI 1.43-5.25), coronary artery disease MESHD (OR: 3.78, 95% CI 2.42-5.90), and cardiovascular disease MESHD (OR: 2.61, 95% CI 1.89-3.62) were significantly associated with mortality. Arrhythmia HP Arrhythmia MESHD (OR: 7.03, 95% CI 2.79-17.69), acute cardiac injury MESHD (OR: 15.58, 95% CI 5.15-47.12), coronary heart disease MESHD (OR: 2.61, 95% CI 1.09-6.26), cardiovascular disease MESHD (OR: 3.11, 95% CI 1.59-6.09), and hypertension HP hypertension MESHD (OR: 1.95, 95% CI 1.41-2.68) were also significantly associated with ICU admission in COVID-19 patients. Conclusion: Findings of this study revealed a high burden of CVDs among COVID-19 patients, which was significantly associated with mortality and ICU admission. Proper management of CVD MESHD patients with COVID-19 and monitoring COVID-19 patients for acute cardiac conditions is highly recommended to prevent mortality and critical situations.

    Characteristics and outcomes of a cohort of SARS-CoV-2 patients in the Province of Reggio Emilia, Italy

    Authors: Paolo Giorgi Rossi; Massimiliano Marino; Debora Formisano; Francesco Venturelli; Massimo Vicentini; Roberto Grilli; - The Reggio Emilia COVID-19 Working Group

    doi:10.1101/2020.04.13.20063545 Date: 2020-04-16 Source: medRxiv

    Objectives. To describe the age TRANS- and sex-specific prevalence SERO of SARS-CoV-2 disease MESHD (COVID-19) and its prognostic factors. Design. Population-based prospective cohort study on archive data. Setting. Preventive services and hospital care in the province of Reggio Emilia, Northern Italy. Participants. All 2653 symptomatic patients who tested positive for SARS-CoV-2 from February 27 to April 2, 2020 in the province of Reggio Emilia. Main outcome measures. Hospitalization and death up to April 2, 2020. Results. Females TRANS had higher prevalence SERO of infection MESHD than males TRANS below age TRANS 50 (2.61 vs. 1.84 per 1000), but lower in older ages TRANS (16.49 vs. 20.86 per 1000 over age TRANS 80). Case fatality rate reached 20.7% (22/106) in cases with more than 4 weeks follow up. After adjusting for age TRANS and comorbidities, men had a higher risk of hospitalization (hazard ratio (HR) 1.4 95% confidence interval (95% CI) 1.2 to 1.6) and of death (HR 1.6, 95% CI 1.2 to 2.1). Patients over age TRANS 80 compared to < age TRANS 50 had HR 7.1 (95% CI 5.4 to 9.3) and HR 27.8 (95% CI 12.5 to 61.7) for hospitalization and death MESHD, respectively. Immigrants had a higher risk of hospitalization (HR 1.3, 95% CI 0.99 to 1.81) than Italians and a similar risk of death MESHD. Risk of hospitalization and of death MESHD were higher in patients with heart failure MESHD (HR 1.6, 95% CI 1.2 to 2.1and HR 2.3, 95% CI 1.6 to 3.2, respectively), arrhythmia HP arrhythmia MESHD (HR 1.5, 95% CI 1.2 to 1.9 and HR 1.8, 95% CI 1.3 to 2.5, respectively), dementia HP dementia MESHD (HR 1.2, 95% CI 0.9 to 1.8 and HR 1.8, 95% CI 1.1 to 2.8, respectively), ischemic MESHD heart disease MESHD (HR 1.3, 95% CI 1.0 to 1.7 and HR 1.7, 95% CI 1.2 to 2.5, respectively), diabetes MESHD (HR 1.5, 95% CI 1.3 to 1.9 and HR 1.6, 95% CI 1.1 to 2.2, respectively), and hypertensions HP hypertensions MESHD(HR 1.4, 95% CI 1.2 to 2.6 and HR 1.6, 95% CI 1.2 to 2.1, respectively), while COPD increased the risk of hospitalization (HR 1.9, 95% CI 1.4 to 2.5) but not of death MESHD (HR 1.1, 95% CI 0.7 to 1.7). Previous use of ACE inhibitors has no effect on risk of death (HR 0.97, 95% CI 0.69 to 1.34) Conclusions. The mechanisms underlying these associations are mostly unknown. A deeper understanding of the causal chain from infection MESHD, disease onset, and immune response to outcomes may explain how these prognostic factors act.

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