Cardiovascular comorbidities may contribute to greater risk of fatal outcomes in COVID-19

COVID-19 patients with underlying cardiovascular comorbidities, such as cardiovascular disease (CVD) and hypertension, appear to face a grim outlook, with acute cardiac injury potentially signalling greater mortality risk, a study has found.

Researchers performed a systematic review of studies evaluating the relationship of underlying CVD, hypertension, and myocardial injury with in-hospital fatal outcomes in patients with COVID-19. Ten studies were included in the meta-analysis, of which two were case series, and the remaining eight were cohort studies. All of them were conducted in Wuhan, China, except for one study that enrolled patients nationwide. 

The total study population comprised 3,118 patients, with the mean age ranging from 49 to 68 years and the proportion of male patients ranging from 45 percent to 67 percent. The prevalence of CVD varied between 4 percent and 15 percent, while that of hypertension varied between 17 percent and 44 percent. Cardiac injury occurred during hospitalization in about 15 percent to 44 percent of patients.

Pooled data revealed that the likelihood of in-hospital mortality was high in the presence of CVD (unadjusted odds ratio [OR], 4.85, 95 percent confidence interval [CI], 3.07–7.70; I², 29 percent) and hypertension (unadjusted OR, 3.67, 95 percent CI, 2.31–5.83; I², 57 percent). Acute cardiac injury was also associated with increased odds (unadjusted OR, 21.15, 95 percent CI, 10.19–43.94; I², 71 percent).

The present data point to the importance of early identification of COVID-19 patients with established cardiovascular comorbidities and acute myocardial injury and of providing more aggressive treatment, the researchers said. Elevated troponin may be considered as an important predictor for mortality risk.