Mortality associated with cardiovascular disease in patients with COVID-19

Cordero, Alberto; García-Gallego, Carlos Santos; Bertomeu-González, Vicente; Fácila, Lorenzo; Rodríguez-Mañero, Moisés; Escribano, David; Castellano, José M.; Zuazola, Pilar; Núñez, Julio; Badimón, Juan J.; Ramón González-Juanatey, José

Introduction and objectives: Cardiovascular disease (CVD) has been outlined as a possible risk factor for poorer outcomes in patients with COVID-19 infection. Methods: A meta-analysis was performed with currently available studies that report the prevalence of CVD in survivors vs non-survivors in patients with COVID-19 infection using reports available at 16 July 2020. Analyses were performed by a random effects model and sensitivity analyses were performed for the identification of potential sources of heterogeneity or assess the small-study effects. Results: A total of 307 596 patients from 16 reports were included and 46 321 (15.1%) had CVD. Globally, mortality rate was 8.2% (20 534 patients) and mortality rates were higher in hospital registries (48.7%) compared to national reports (23.1%). A total of 11 213 (24.2%) patients with CVD died and mortality rates were also higher in hospital registries (48.7%) compared to national reports (23.1%). CVD was associated to 4-fold higher risk of mortality (OR, 4.33; 95%CI, 3.16-5.94). Data from 28 048 patients with diabetes was available. Diabetes was associated to higher mortality risk (OR, 2.41; 95%CI, 1.79-3.26; P < .001). From 40 173 subjects with hypertension it could also be proven a risk factor for higher mortality (OR, 2.60; 95%CI, 2.10-3.21; P < .001). Conclusions: patients with CVD and COVID-19 infection have 4-fold higher risk of death. Diabetes or hypertension are also associated with higher mortality risk.