Incidence of cardiac complications following COVID-19 infection: An umbrella meta-analysis study

Abstract

Background COVID-19 causes fatal cardiac damages. Despite many overwhelming meta-analysis related to cardiac complications following COVID-19 disease, no umbrella meta-analysis study has been conducted. Objectives We aimed to report the summarized pooled incidences of cardiac complications in the overall, critically ill, and deceased patients, compare the cardiac complications between the severe/non-severe or deceased/non-deceased patients, and also compare poor outcomes between patients with/without acute myocardial injury (AMI). Methods PubMed, Scopus, web of science, Cochrane, ProQuest, Springer, Sage journals were searched before April 2021. After assessing the quality and duplicate data, data were run by the random/fixed-effect models, I2 heterogeneity index, Egger's test, and sensitivity analysis. Results After removing duplicate data, in the overall COVID-19 patients, the pooled incidence of AMI, heart failure, arrhythmia, cardiac arrest, and acute coronary syndrome (ACS) were 21%, 14%, 16%, 3.46%, and 1.3% respectively. In the patients with severe disease, the pooled incidence of AMI and shock were 33 and 35%, respectively. Similarly, in the deceased COVID-19 patients, the pooled incidence rate of AMI and arrhythmia were 56% and 47.5%, respectively. The patients with severe disease were at higher risk of AMI (RR = 5.27) and shock (OR = 20.18) compared with the non-severe cases. Incidence of AMI was associated with transfer to the intensive care units (ICU) (RR = 2.92) and mortality (RR=2.57, OR = 8.36), significantly. Conclusion Cardiac complications were found to be increased alarmingly in COVID-19 patients. Baseline and during hospitalization checking with electrocardiography, echocardiography, and measuring of cardiac biomarkers should be applied.

Detection of SARS-CoV-2 Antigens in the AV-Node of a Cardiac Conduction System—A Case Report

“…Despite the increasing number of epidemiological and clinical studies reporting a link between COVID-19 and new-onset cardiac arrhythmias, the mechanism of their development during SARS-CoV-2 infection is still obscure. A recent meta-analysis showed that pooled incidence of cardiac arrhythmias is 16% among overall COVID-19 patients, being the second (after myocardial infarction) most common cardiac complication of COVID-19 [ 4 ]. The proposed pathophysiological mechanism involved in the development of the COVID-19-related arrhythmia includes hypoxemia, myocardial ischemia/hypoxia, systemic inflammation with hypercytokinemia (cytokine storm), dyselectrolytemias, and side effects of some antiviral drugs [ 5 , 6 ].…”

Retrospective assessment of the association between co-morbid disease burden and biochemical parameters in hospitalized hypertensive COVID-19 patients

“…According to data from a different meta-analysis, HT was independently linked to a considerably higher incidence of critical COVID-19 and inhospital COVID-19 mortality [13]. The severity of sickness, ICU hospitalization, death, and other organ damage was several times greater in COVID-19 patients with cardiac injuries than in infected individuals without them [14]. It is concluded that HT worsens the severity of COVID-19 due to underlying endothelial dysfunction and coagulopathy.…”

Oncology and cardiology positron emission tomography/computed tomography faced with COVID-19: A review of available literature data

“…In patients with COVID-19, the pooled incidence of acute myocardial infarction (AMI), heart failure, arrhythmia, cardiac arrest, and ACS was 21, 14, 16, 3.46, and 1.3%, respectively. Patients with severe disease were at higher risk of AMI (RR = 5.27) and shock (OR = 20.18) compared with non-severe cases (196). In addition, myocarditis caused by COVID-19 infection resulted in mortality of approximately 7% (197).…”