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SARS-CoV-2 proteins

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    The role of pre-existing chronic disease in cardiac complications from SARS-CoV-2 infection MESHD: A systematic review and meta-analysis

    Authors: Jane E Sinclair; Yanshan Zhu; Gang Xu; Wei Ma; Haiyan Shi; Kun-Long Ma; Chun-Feng Cao; Ling-Xi Kong; Ke-Qiang Wan; Juan Liao; Hai-Qiang Wang; Matt Arentz; Meredith Redd; Linda A Gallo; Kirsty R Short

    doi:10.1101/2020.06.21.20136622 Date: 2020-06-23 Source: medRxiv

    ABSTRACT Importance: SARS-CoV-2 is associated with multiple direct and indirect effects to the heart. It is not yet well defined whether patient groups at increased risk of severe respiratory disease MESHD due to SARS-CoV-2 infection MESHD also experience a heightened incidence of cardiac complications MESHD. Objective: We sought to analyse the role of pre-existing chronic disease MESHD ( chronic respiratory illness MESHD, cardiovascular disease MESHD ( CVD MESHD), hypertension MESHD and diabetes mellitus MESHD) in the development of cardiac complications from SARS-CoV-2. Data Sources: We retrospectively investigated published (including pre-prints), publicly released, de-identified, data made available between Dec 1 HGNC, 2019, and May 11, 2020. Information was accessed from PubMed, Embase, medRxiv and SSRN. Study Selection: 379 full-text articles were reviewed and 321 excluded for lack of original research, irrelevance to outcome, inappropriate cohort MESHD, or small patient numbers (case reports of <10 patients). Data were extracted from two studies and the remaining 56 contacted to request appropriate data, to which three responded with data contributions. A final of five studies were included. Data Extraction and Synthesis: This systematic review was conducted based on PRISMA and MOOSE statements. Included studies were critically appraised using Newcastle Ottawa Quality Assessment Scale ( NOS HGNC). Data were extracted independently by multiple observers. A fixed-effects model was selected for the meta-analysis based on relatively low heterogeneity between the studies (I2<50%). Main Outcome and Measures: Cardiac complications were determined via blood levels of cardiac biomarkers above the 99th percentile of the upper reference limit, abnormalities in electrocardiography, and/or abnormalities in echocardiography. Results: SARS-CoV-2-infected MESHD patients who developed cardiac complications MESHD were, on average, 10 years older than those that did not. Pooled analyses showed the development of cardiac complications from SARS-CoV-2 was significantly increased in patients with underlying chronic respiratory illness MESHD (OR 2.88[1.45,5.71]), CVD MESHD (OR 5.12[3.09,8.48]), hypertension MESHD (OR 4.37[2.99,6.39]) and diabetes mellitus MESHD (OR 2.61[1.67,4.09]). Conclusions and Relevance: Older age and pre-existing chronic respiratory illness MESHD, CVD MESHD, hypertension MESHD, and diabetes mellitus MESHD may represent prognostic factors for the development of additional cardiac complications in COVID-19 MESHD, highlighting the need for a multidisciplinary approach to chronic disease MESHD patient management and providing justification for a larger scale observational study.

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MeSH Disease
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SARS-CoV-2 Proteins


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