Cardio-Cerebrovascular Disease is Associated With Severity and Mortality of COVID-19: A Systematic Review and Meta-Analysis

Biol Res Nurs. 2021 Apr;23(2):258-269. doi: 10.1177/1099800420951984. Epub 2020 Aug 27.

Abstract

At present, COVID-19 is raging all over the world. Many comorbidities, such as diabetes mellitus (OR = 2.67, 95% CI = 1.91-3.74) and hypertension (OR = 2.3, 95% CI = 1.76-3.00), have been shown to worsen the patient's condition. However, whether cardio-cerebrovascular disease will affect COVID-19 remains unclear. In this meta-analysis, we collected studies from PubMed, Wed of Science and CNKI (Chinese) to July 25, which reported COVID-19 patients with and without cardio-cerebrovascular disease as well as their severity and mortality. The random-effect model meta-analysis was used to analyze them and get overall odds ratios (OR) with 95% CIs. Funnel plots and the Begg's and Egger's test were used to assess publication bias. Thirty-one studies with 23,632 patients were finally included in the meta-analysis. The results showed an OR of 3.004 (95% CI = 2.097-4.303) for COVID-19 severity and an OR of 5.587 (95% CI = 2.810-11.112) for COVID-19 mortality. Compared with cardiovascular disease, the subgroup analysis indicated that cerebrovascular disease was more likely to increase the severity (OR = 3.400, 95% CI = 1.569-7.368) and mortality (OR = 23.477, 95% CI = 3.050-180.735) of COVID-19. Therefore, it can be inferred that cardio-cerebrovascular disease is associated with an increase in the risk of severe illness and death among COVID-19 patients. This meta-analysis showed that cardio-cerebrovascular disease has a significant relation with severe and death outcomes of COVID-19. Nurses should pay special attention to COVID-19 patients with the cardio-cerebrovascular disease.

Keywords: COVID-19; cardio-cerebrovascular disease; meta-analysis; severity; mortality.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asian People
  • COVID-19 / epidemiology*
  • COVID-19 / mortality*
  • Cardiovascular Diseases / complications*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / mortality*
  • Cause of Death*
  • Cerebrovascular Disorders / complications*
  • Cerebrovascular Disorders / epidemiology
  • Cerebrovascular Disorders / mortality*
  • Comorbidity
  • Female
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • SARS-CoV-2
  • Severity of Illness Index