Effect of Coronary Artery Disease on COVID-19—Prognosis and Risk Assessment: A Systematic Review and Meta-Analysis
Lukasz Szarpak,
Malgorzata Mierzejewska,
Jonasz Jurek,
Anna Kochanowska,
Aleksandra Gasecka,
Zenon Truszewski,
Michal Pruc,
Natasza Blek,
Zubaid Rafique,
Krzysztof J. Filipiak,
Andrea Denegri,
Milosz J. Jaguszewski
Affiliations
Lukasz Szarpak
Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, 03-411 Warsaw, Poland
Malgorzata Mierzejewska
1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
Jonasz Jurek
1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
Anna Kochanowska
1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
Aleksandra Gasecka
1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
Zenon Truszewski
Department of Emergency Medicine, Medical University of Warsaw, 02-005 Warsaw, Poland
Michal Pruc
Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
Natasza Blek
Institute of Clinical Medicine, Maria Sklodowska-Curie Medical Academy, 04-311 Warsaw, Poland
Zubaid Rafique
Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
Krzysztof J. Filipiak
Institute of Clinical Medicine, Maria Sklodowska-Curie Medical Academy, 04-311 Warsaw, Poland
Andrea Denegri
Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41121 Modena, Italy
Milosz J. Jaguszewski
1st Department of Cardiology, Medical University of Gdansk, 80-294 Gdansk, Poland
Coronary artery disease (CAD) is the leading cause of death worldwide. Patients with pre-existing CAD were shown to have a more severe course of COVID-19, but this association has not been clarified. We performed a meta-analysis to determine the association between CAD and COVID-19 outcomes. We searched Scopus, Medline (PubMed), Web of Science, Embase, and Cochrane databases up to 2 November 2021. There were 62 studies with a total population of 49,286 patients included in the meta-analysis. CAD occurrence in survivor vs. non-survivor groups varied and amounted to 9.2% vs. 22.9%, respectively (OR = 0.33; 95%CI: 0.29 to 0.39; I2 = 70%; p 2 = 72%; p < 0.001). The role of history of CAD in mortality and severe condition in COVID-19 presents itself as prominent—although a risk of bias in retrospective trials needs to be assessed, in case of our meta-analysis the statistically significant results when it comes to higher mortality among patients with CAD compared to non-CAD patients, a more severe condition observed in patients with CAD, and a visibly more frequent admission to intensive care unit in patients with CAD, it seems that an incidence of cardiovascular events plays a role in COVID-19 prognosis.
