Association of Cardiovascular Disease With Coronavirus Disease 2019 (COVID-19) Severity: A Meta-Analysis

Aggarwal, Gaurav; Cheruiyot, Isaac; Aggarwal, Saurabh; Wong, Johnny; Lippi, Giuseppe; Lavie, Carl J.; Henry, Brandon Michael; Sanchís-Gomar, Fabián

doi:10.1016/j.cpcardiol.2020.100617

Cited by 157 publications

(149 citation statements)

References 27 publications

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“…The third finding of our meta-analysis is that the presence of cardiovascular diseases, is associated with a higher risk of mortality when compared to COVID-19 patients without pre-existing CVD. Our outcomes are in contrast with the results of a previous meta-analysis conducted on three studies, which found no correlation between the history of CVD and mortality but revealed an association between CVD and enhanced disease severity [ 5 ]. It is possible that such a discrepancy could be due to the difference in terms of number of studies included in the analysis.…”

Section: Discussioncontrasting

confidence: 99%

“…Previous literature suggests that patients with pre-existing cardiovascular disease (CVD) might be potentially more susceptible to infection from SARS-CoV-2 [ 3 ]. Nevertheless, the exact mechanisms by which COVID-19 affects the cardiovascular system and mortality are not yet well understood, despite accumulating evidence that such a connection exists [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Quantification of Death Risk in Relation to Sex, Pre-Existing Cardiovascular Diseases and Risk Factors in COVID-19 Patients: Let’s Take Stock and See Where We Are

Moula

Micali

Matteucci

et al. 2020

JCM

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Patients with pre-existing cardiovascular disease (CVD) might be more susceptible to infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and have higher mortality rates. Nevertheless, the risk of mortality has not been previously quantified. The aim of this meta-analysis is to quantify the risk of mortality in coronavirus disease 2019 (COVID-19) patients. A meta-analysis was conducted analyzing the impact of (1) sex, (2) age, (3) CVD with coronary artery disease (CAD), (4) CAD alone, (5) CVD without CAD, (6) hypertension, (7) cerebrovascular diseases, and (8) diabetes on mortality. Relative risk was assessed for dichotomous variables, mean difference for continuous variables. Twenty-six studies were included, encompassing 8497 patients. Males had 16% higher risk of mortality than females (p < 0.05) and elderly patients had higher chance of dying than younger patients (p < 0.0001). Patients with overall CVD have a 1.96-fold higher mortality risk (p < 0.0001). CAD increases risk of mortality by 1.90-fold (p < 0.05). CVD-CAD were found to increase risk up to 2.03-fold (p < 0.05). Hypertension, cerebrovascular disease and diabetes increase the risk of death up to 1.73-fold, 1.76-fold and 1.59-fold, respectively (p < 0.0001, p < 0.0001, p < 0.05, respectively). Sex, age, presence of CAD and/or other types of CVD, hypertension, cerebrovascular diseases and diabetes mellitus increase mortality in patients with COVID-19.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Quantification of Death Risk in Relation to Sex, Pre-Existing Cardiovascular Diseases and Risk Factors in COVID-19 Patients: Let’s Take Stock and See Where We Are

Moula

Micali

Matteucci

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…On the other hand, it is undisputed that patients with comorbidities are more vulnerable to cardiac complications if they succumb to COVID-19 [ 54 ]. Patients with pre-existing CVD and hypertension are widely representative of poorer prognosis and have a higher risk of dying due to SARS-CoV-2 infection [ 51 , 55 ]. The ACE2 receptor, which is responsible for SARS-CoV-2 entry into host cells, is highly expressed in perivascular pericytes and cardiomyocytes.…”

Section: Sars-cov-2 Infectivity Symptoms and Complicationsmentioning

confidence: 99%

Targeting the SphK-S1P-SIPR Pathway as a Potential Therapeutic Approach for COVID-19

McGowan

Haddadi

Nassif

et al. 2020

IJMS

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The world is currently experiencing the worst health pandemic since the Spanish flu in 1918—the COVID-19 pandemic—caused by the coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This pandemic is the world’s third wake-up call this century. In 2003 and 2012, the world experienced two major coronavirus outbreaks, SARS-CoV-1 and Middle East Respiratory syndrome coronavirus (MERS-CoV), causing major respiratory tract infections. At present, there is neither a vaccine nor a cure for COVID-19. The severe COVID-19 symptoms of hyperinflammation, catastrophic damage to the vascular endothelium, thrombotic complications, septic shock, brain damage, acute disseminated encephalomyelitis (ADEM), and acute neurological and psychiatric complications are unprecedented. Many COVID-19 deaths result from the aftermath of hyperinflammatory complications, also referred to as the “cytokine storm syndrome”, endotheliitus and blood clotting, all with the potential to cause multiorgan dysfunction. The sphingolipid rheostat plays integral roles in viral replication, activation/modulation of the immune response, and importantly in maintaining vasculature integrity, with sphingosine 1 phosphate (S1P) and its cognate receptors (SIPRs: G-protein-coupled receptors) being key factors in vascular protection against endotheliitus. Hence, modulation of sphingosine kinase (SphK), S1P, and the S1P receptor pathway may provide significant beneficial effects towards counteracting the life-threatening, acute, and chronic complications associated with SARS-CoV-2 infection. This review provides a comprehensive overview of SARS-CoV-2 infection and disease, prospective vaccines, and current treatments. We then discuss the evidence supporting the targeting of SphK/S1P and S1P receptors in the repertoire of COVID-19 therapies to control viral replication and alleviate the known and emerging acute and chronic symptoms of COVID-19. Three clinical trials using FDA-approved sphingolipid-based drugs being repurposed and evaluated to help in alleviating COVID-19 symptoms are discussed.

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“…Our understanding of factors associated with higher mortality is still evolving. Recent reports show that mortality is higher among patients with hypertension, chronic obstructive pulmonary disease (COPD), hypercholesterolemia, diabetes mellitus (DM), and cardiovascular disease, as well as in older men [ 2 , 3 ]. There is intense interest in studying the impact of modifiable host factors, such as smoking, on the severity of COVID-19 infection for early identification of individuals at higher risk of mortality and targeted prevention of adverse outcomes.…”

Section: Introductionmentioning

confidence: 99%

Smoking Doubles the Mortality Risk in COVID-19: A Meta-Analysis of Recent Reports and Potential Mechanisms

Salah¹,

Sharma²,

Mehta³

2020

Cureus

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Introduction Studies have reported conflicting results regarding the effect of smoking on outcome in coronavirus disease 2019 (COVID-19) patients, but the results have been conflicting. In this meta-analysis, we systematically examined the association between smoking and mortality in COVID-19. Methods PubMed database was searched to look for relevant articles. Inclusion criteria were as follows: (1) cohort studies or case series studies; (2) study population included individuals with a confirmed COVID-19 infection; (3) the status of smoking was reported, regardless if it was current or in the past; and (4) mortality among smokers was reported in the study or could be calculated and compared to non-smokers. Mortality rates were pooled using a random effects model. Risk ratio (RR) and its 95% confidence interval (CI) were also calculated using the same model. Another meta-analysis was then performed to assess the difference in mortality between current and former smokers. Results Ten studies with a total of 11,189 patients were included. Mortality among smokers was 29.4% compared to 17.0% among non-smokers. RR was 2.07 (95% CI: 1.59, 2.69). Based on analysis of four studies (532 patients), there was no difference in mortality risk between current and former smokers (RR: 1.03; 95% CI: 0.75, 1.40). Conclusions Smoking, current or past, is associated with higher mortality in COVID-19 patients. Mortality among current smokers was about 50% greater than former smokers, but the difference was not statistically significant.

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Association of Cardiovascular Disease With Coronavirus Disease 2019 (COVID-19) Severity: A Meta-Analysis

Cited by 157 publications

References 27 publications

Quantification of Death Risk in Relation to Sex, Pre-Existing Cardiovascular Diseases and Risk Factors in COVID-19 Patients: Let’s Take Stock and See Where We Are

Quantification of Death Risk in Relation to Sex, Pre-Existing Cardiovascular Diseases and Risk Factors in COVID-19 Patients: Let’s Take Stock and See Where We Are

Targeting the SphK-S1P-SIPR Pathway as a Potential Therapeutic Approach for COVID-19

Smoking Doubles the Mortality Risk in COVID-19: A Meta-Analysis of Recent Reports and Potential Mechanisms

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