Meta-analysis Comparing Outcomes in Patients With and Without Cardiac Injury and Coronavirus Disease 2019 (COVID 19).
Am J Cardiol
; 141: 140-146, 2021 02 15.
Article
in English
| MEDLINE | ID: covidwho-1059826
ABSTRACT
Current evidence is limited to small studies describing the association between cardiac injury and outcomes in patients with coronavirus disease 2019 (COVID-19). To address this, we performed a comprehensive meta-analysis of studies in COVID-19 patients to evaluate the association between cardiac injury and all-cause mortality, intensive care unit (ICU) admission, mechanical ventilation, acute respiratory distress syndrome, acute kidney injury and coagulopathy. Further, studies comparing cardiac biomarker levels in survivors versus nonsurvivors were included. A total of 14 studies (3,175 patients) were utilized for the final analysis. Cardiac injury in patients with COVID-19 was associated with higher risk of mortality (risk ratio [RR]7.79; 95% confidence interval [CI] 4.69 to 13.01; I2=58%), ICU admission (RR 4.06; 95% CI 1.50 to 10.97; I2â¯=â¯61%), mechanical ventilation (RR 5.53; 95% CI 3.09 to 9.91; I2â¯=â¯0%), and developing coagulopathy (RR 3.86; 95% CI2.81 to 5.32; I2â¯=â¯0%). However, cardiac injury was not associated with increased risk of acute respiratory distress syndrome (RR3.22; 95% CI0.72 to 14.47; I2â¯=â¯73%) or acute kidney injury (RR 11.52, 95% CI0.03 to 4,159.80; I2â¯=â¯0%). The levels of hs-cTnI (MD34.54 pg/ml;95% CI 24.67 to 44.40 pg/ml; I2â¯=â¯88%), myoglobin (MD186.81 ng/ml; 95% CI 121.52 to 252.10 ng/ml; I2â¯=â¯88%), NT-pro BNP (MD1183.55 pg/ml; 95% CI 520.19 to 1846.91 pg/ml I2â¯=â¯96%) and CK-MB (MD2.49 ng/ml;95% CI 1.86 to 3.12 ng/ml; I2â¯=â¯90%) were significantly elevated in nonsurvivors compared with survivors with COVID-19 infection. The results of this meta-analysis suggest that cardiac injury is associated with higher mortality, ICU admission, mechanical ventilation and coagulopathy in patients with COVID-19.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pandemics
/
COVID-19
/
Heart Diseases
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Reviews
Limits:
Humans
Language:
English
Journal:
Am J Cardiol
Year:
2021
Document Type:
Article
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