Background: Cardiometabolic comorbidities have been associated with a higher risk of COVID-19 severity and mortality, but more investigations are needed to determine which comorbidity is more detrimental.
Methods: Embase, Emcare, and MEDLINE were searched systematically for prospective and retrospective studies assessing the associations of cardiometabolic risk factors and COVID-19 outcomes of hospitalization, severity, and mortality among COVID-19-diagnosed patients. Literature search was performed from first publication to May 19, 2021. Study quality was assessed by the Newcastle-Ottawa Scale.
Results: From the literature search, 301 studies suggested that all included cardiometabolic risk factors were associated with a higher risk of COVID-19 hospitalization, severity, and mortality, except that overweight was associated with a decreased risk of mortality (relative risk [RR] 0.88; 95% CI, 0.80-0.98). Patients with diabetes (RR 1.46; 95% CI, 1.45-1.47) were most likely to be hospitalized; patients with heart failure had the highest risk for severe COVID-19 outcomes (RR 1.89; 95% CI, 1.71-2.09); while patients with stroke were most susceptible to overall mortality (RR 1.99; 95% CI, 1.90-2.08). In the network meta-analysis, cerebrovascular disease had the highest impact (RR 1.69; 95% CI, 1.65-1.73) on COVID-19 outcomes compared to other cardiometabolic risk factors. For different combinations of risk factors, cardiovascular disease and diabetes combined (RR 6.98; 95% CI, 5.28-9.22) was more detrimental than others.
Conclusions: Considering the high prevalence of cardiometabolic comorbidities and risk of all severe outcomes, patients with cardiometabolic comorbidities should be prioritized in vaccination and treatment development of COVID-19.
背景:心血管代谢疾病已被证实与COVID-19的严重程度和死亡率增加有关, 但需要进一步研究来确定哪种疾病更具危害性。 方法:对Embase、Emcare和MEDLINE®进行系统检索, 评估心血管代谢危险因素与COVID-19患者住院、严重程度和死亡率之间的关联。文献检索从首次发表到2021年5月19日。研究质量由纽卡斯尔-渥太华量表评估。 结果:从文献检索中, 共有301项研究表明, 除超重与死亡率降低的风险相关(RR 0.88, 95% CI:0.80至0.98)外, 所有包括的心血管代谢危险因素都与COVID-19住院、严重程度和死亡率增加的风险相关。糖尿病患者最有可能住院(RR 1.46, 95% CI:1.45至1.47), 心力衰竭患者最容易出现严重COVID-19结果(RR 1.89, 95% CI:1.71至2.09), 而卒中患者最容易发生总体死亡率(RR 1.99, 95% CI:1.90至2.08)。在网络meta分析中, 与其他心血管代谢危险因素相比, 脑血管疾病对COVID-19结果的影响最大(RR 1.69, 95% CI:1.65至1.73)。对于不同的危险因素组合, 心血管疾病和糖尿病的组合(RR 6.98, 95% CI:5.28至9.22)比其他组合更具危害性。 结论:考虑到心血管代谢疾病的高发病率和所有严重结果的风险, 患有心血管代谢疾病的患者应优先接种疫苗并参与COVID-19的治疗。.
Keywords: 2019冠状病毒病; COVID-19; cardiometabolic risk factors; network meta-analysis; 心血管代谢危险因素; 网络meta分析.
© 2023 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.