A meta-analysis on the role of pre-existing chronic disease in the cardiac complications of SARS-CoV-2 infection

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

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been associated with multiple direct and indirect cardiovascular complications. We sought to analyse the association of host co-morbidities (chronic respiratory illnesses, cardiovascular disease (CVD), hypertension or diabetes mellitus (DM)) with the acute cardiovascular complications associated with SARS-CoV-2 infection. Individual analyses of the majority of studies found median age was higher by ∼10 years in patients with cardiovascular complications. Pooled analyses showed development of SARS-CoV-2 cardiovascular complications was significantly increased in patients with chronic respiratory illness (odds ratio (OR) 1.67[1.48,1.88]), CVD (OR 3.37[2.57,4.43]), hypertension (OR 2.68[2.11,3.41]), DM (OR 1.60[1.31,1.95]) and male sex (OR 1.31[1.21,1.42]), findings that were mostly conserved during sub-analysis of studies stratified into global geographic regions. Age, chronic respiratory illness, CVD, hypertension, DM and male sex may represent prognostic factors for the development of cardiovascular complications in COVID-19 disease, highlighting the need for a multidisciplinary approach to chronic disease patient management.