Abstract
Background: The COVID-19 pandemic has had a profound impact on global health, revealing vulnerabilities in populations with pre-existing conditions. It has placed focus on the intersection of infectious diseases with chronic conditions, notably cardiovascular diseases. These have emerged as significant concerns due to their potential to exacerbate COVID-19 outcomes.
Objective: To estimate the prevalence of coronary artery disease (CAD) among COVID-19 patients.
Methods: In this systematic review and meta-analysis, an extensive literature search was conducted in seven databases and preprint servers till 2023-04-13 as per a pre-registered protocol (CRD42022367501). Primary studies reporting CAD among COVID-19 patients were included. Individual study estimates were pooled using the random-effects model due to the heterogeneity. Prediction interval was used to identify the range into which future studies are expected to fall. Subgroup analysis and meta-regression were done to reduce heterogeneity, followed by publication bias and quality assessments.
Results: 33 studies with 40,064 COVID-19 patients revelaed a pooled prevalence of coronary artery disease of 15.24% (95% CI: 11.41% - 20.06%). The 95% prediction interval ranged from 2.49% to 55.90%. The studies were highly heterogeneous (tau-sqaured=0.89), and subgroup analysis significantly reduced it (P=.002). Europe reported the highest prevalence [21.70% (14.80% - 30.65%)], and Asia has the least prevalence [10.07% (6.55% - 15.19%)]. A symmetric doi plot and an LFK index of 0.57 revealed no evidence of publication bias.
Conclusions: The substantial prevalence of CAD among COVID-19 patients underscores the need for high clinical vigilance. The geographical disparities suggest potential regional differences in healthcare infrastructure, genetic predispositions, or lifestyle factors that warrant further investigation. The findings emphasize the importance of routine cardiac assessments for COVID-19 patients for timely interventions and better patient outcomes.
Keywords:
Coronary artery disease, COVID-19, Ischaemic heart disease, Myocardial infarction, Heart attack, Systematic Review, Meta-analysis, Angina pectoris, Coronavirus, Evidence synthesisReferences
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