C90 PRE–EXISTING CORONARY ARTERY DISEASE AMONG COVID–19 PATIENTS: A SYSTEMATIC REVIEW AND META–ANALYSIS

Abstract

BackgroundThe prevalence and prognostic implications of coronary artery disease (CAD) in patients infected by the novel coronavirus 2019 (COVID–19) disease remain unclear.MethodsWe conducted a systematic review and meta–analysis to investigate the prevalence and mortality risk in COVID–19 patients with pre–existing CAD. We searched Medline and Scopus to locate all articles published up to December 8, 2021, reporting data of COVID–19 survivors and non–survivors with pre–existing CAD. Data were pooled using the Mantel–Haenszel random effects models with odds ratio (OR) as the effect measure with the related 95% confidence interval (CI). ResultsThirty–eight studies including 27.435 patients [mean age 61.5 and 70.9 years] were analysed. The pooled prevalence of pre–existing CAD was 12.6% (95% CI: 11.2–16.5%, I2:95.6%), and resulted higher in ICU patients (17.5%, 95% CI: 11.9–25.1, I2: 88.4%) and in European cohorts (13.1%, 95% CI: 7.8–21.6%, p < 0.001, I2: 98.4%). COVID–19 patients with pre–existing CAD had a twofold risk of short–term mortality (OR 2.61, 95% CI 2.10–3.24, p < 0.001, I2=73.6%) (Figure 1); this risk was higher among Asian cohorts (OR: 2.66, 95% CI: 1.79–3.90, p < 0.001, I2: 77.3%) compared to European (OR: 2.44, 95% CI: 1.90–3.14, p < 0.001, I2:56.9%) and American (OR: 1.86, 95% CI: 1.41–2.44, p < 0.001, I2: 0%) populations (Figure 2). The association between CAD and poor short–term prognosis was influenced by age, prevalence of HT, DM and CKD. ConclusionsPre–existing CAD is present in approximately 1 in 10 patients hospitalised for COVID–19 and significantly associated with an increased risk of short–term mortality, which is influenced by age, HT, DM and CKD.