Covid-19: Risk and Cardiovascular Disease. Systematic Review 2022

Abstract

Objective: To identify through a review of scientific literature the association between cardiovascular diseases and severity in the clinical picture of patients with Covid-19 Design and method: To answer the PICO question: is there an association between cardiovascular diseases and the severity of the clinical picture of patients with Covid-19? An exhaustive review of scientific articles based on the PRISMA methodology was carried out, between June 16 and July 26, 2022, in the PubMed, UpToDate, ScienceDirect, Scielo, and National Library of Medicine databases. The terms Mesh, Patient, Men, Womans, Age, Sex, COVID-19, Coronavirus, Sars-Cov-2, Cardiovascular Diseases, Heart Disease, Risk Factors, Myocardial infarction, Stroke, were combined with Boolean AND OR NOT operators and were entered into database search engines. The established limits were type of study, type of document, language, date of publication. Studies referring to children and adolescents, pregnant women were excluded; Studies referring to adult patients with Covid-19 with and without a history of cardiovascular disease were included. The studies identified after passing the established filters were assessed for methodological quality with Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) applied to observational studies. Those preselected underwent an assessment of the level of evidence with the proposal of the Oxford Center for Evidence-Based Medicine (CEBM), those who obtained a high level and grade of recommendation were included in this review. Results: Six studies that passed all the filters were selected. An association was identified between diseases and cardiovascular risk with the severity of the clinical picture and in some cases fatal outcome. Associated comorbidities were: diabetes (OR 3.39 95% CI, 2.14-5.37); p = 0.0001, z = 5.206; (OR 2.61, 95% CI: 2.02–3.39), (OR: 2.27, 95% CI: 1.87–2.74); cerebrovascular disease (OR 4.85, 95% CI: 3.11–7.57); cardiovascular disease (OR 4.81, 95% CI: 3.43–6.74), (OR:3.44, 95% CI: 2.65–4.48); hypertension (OR: 2.51, 95% CI: 2.13–2.95). Conclusions: The cardiovascular risk and diseases predispose to the development of critical illness, with longer hospital stays, admission to intensive care units, application of mechanical ventilation, and in some cases the death of patients who contract Covid-19.