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Review|Volume 12, Issue 22|pp 23409—23421

Impact of cardiovascular and metabolic diseases on the severity of COVID-19: a systematic review and meta-analysis

Meng Meng1, Qianwen Zhao2, Rahul Kumar3, Chen Bai4, Yunlei Deng5, Bo Wan6
  • 1Digestion Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
  • 2Department of Gastroenterology and Hepatology, Sichuan University-Oxford University Huaxi Gastrointestinal Cancer Centre, West China Hospital, Sichuan University, Chengdu, China
  • 3Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore
  • 4Beijing University of Chinese Medicine, Beijing, China
  • 5Department of Nephrology, The Third People’s Hospital of Chengdu, Chengdu, China
  • 6Centre for Stem Cells and Regenerative Medicine, King’s College London, Guy’s Hospital, Great Maze Pond, London, UK
* Equal contribution and co-first authors
Received: June 16, 2020Accepted: August 15, 2020Published: November 16, 2020
https://doi.org/10.18632/aging.103991

Copyright: © 2020 Meng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

We examined the effects of coronary heart disease (CHD), hypertension and diabetes on the development of severe COVID-19. We performed a comprehensive, systematic literature search for studies published between December 2019 and July 5, 2020 in five databases. The prevalence of severe COVID-19 in patients with CHD, hypertension and diabetes was evaluated through a meta-analysis. Thirty-five articles with 8,170 patients were included, and all the available studies were case series. The pooled odds ratio for the development of severe COVID-19 was 3.21 for patients with CHD (fixed-effects model, 95% CI: 2.58-3.99), 2.27 for patients with hypertension (random-effects model, 95% CI: 1.79-2.90) and 2.34 for patients with diabetes (random-effects model, 95% CI: 1.79-3.05). The heterogeneity of the studies was moderate for the effect of CHD on COVID-19 severity, but was high for the effects of diabetes and hypertension. Funnel plots and Egger’s tests revealed no publication bias in the CHD and hypertension analyses, but suggested publication bias in the diabetes analysis. This bias was corrected using the trim-and-fill method, and was ultimately found to have no effect on the results. Our findings suggest patients with CHD, hypertension and diabetes are at greater risk for developing severe COVID-19 than those without these conditions.