The relationship of COVID-19 severity with cardiovascular disease and its traditional risk factors: A systematic review and meta-analysis

Kunihiro Matsushita; Ning Ding; Minghao Kou; Xiao Hu; Mengkun Chen; Yumin Gao; Yasuyuki Honda; David Dowdy; Yejin Mok; Junichi Ishigami; Lawrence J Appel

The positive association of sociodemographic factors (age, male sex, and smoking) with severe COVID-19 is consistent with reports of other infectious diseases (e.g., influenza virus and SARS in 2003). [27] [28] [29] There are several plausible mechanisms. Older age is linked to reduced immune reaction, more comorbidities, and limited organ reserve. 3, 27, 30 Male sex is related to higher prevalence of comorbidities, less frequency of washing hands, and immunological disadvantage given X-chromosome coding proteins in the immune system, 2,31,32 whereas smoking can damage respiratory system. 33 In our meta-analysis, we confirmed overall positive crude associations of CVD, hypertension, and diabetes with severe COVID-19, with pooled relative risk estimates around 3-. CC-BY-NC-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity.