Meta-analysis of Cardiovascular Events and Related Biomarkers Comparing Survivors vs. Non-survivors in Patients with COVID-19

Am J Cardiol. 2020 Sep 8;S0002-9149(20)30902-4. doi: 10.1016/j.amjcard.2020.08.044. Online ahead of print.

Abstract

Since the emergence of the coronavirus disease 19 (COVID-19), a number of studies have reported the presence of cardiovascular diseases in affected patients and linked them with a higher risk of mortality. We conducted an online search in Medline/PubMed to identify original cohorts comparing data between survivors and non-survivors from COVID-19. The presence of cardiovascular events and related biomarkers were compared between the two groups. Data on 1,845 hospitalized patients with COVID-19 were pooled from 12 comparative studies. The overall mortality rate in relation to COVID-19 was 17.6%. Men aged > 50 years old were more likely to die from COVID-19. Significant co-morbidities contributing to mortality were hypertension, diabetes mellitus, smoking, a previous history of cardiovascular disease including chronic heart failure, and cerebrovascular accidents. A significant relationship was observed between mortality and patient presentation with dyspnea, fatigue, tachycardia, and hypoxemia. Cardiovascular disease-related laboratory biomarkers related to mortality were elevated serum level of lactate dehydrogenase, creatine kinase, and cardiac troponin I. Adverse cardiovascular disease-related clinical events preceding death were shock, arrhythmias, and acute myocardial injury. In conclusion, elevated biomarkers in COVID-19 patients with established risk factors can predict mortality from cardiovascular causes.

Keywords: Arrhythmia; COVID-19; Cardiovascular disease; Creatine kinase; Mortality; SARS-CoV-2; Troponins.