Abstract
It is essential to know whether COVID-19 patients have a history of cerebrovascular disease, as it may be predictive of prognosis and useful for allocation of limited medical resources. This meta-analysis was performed to assess the incidence of cerebrovascular disease as a comorbidity in COVID-19 patients. The PubMed, Cochrane Library, Embase, CNKI, WFSD, and VIP databases were systematically searched. The pooled analysis of relevant data was conducted using RevMan 5.3 software. The primary outcome was incidence of cerebrovascular disease as a comorbidity. Forty-seven studies involving 16,143 COVID-19 patients were included in this analysis. The incidences of a history of cerebrovascular disease and hypertension in COVID-19 patients were estimated to be 3.0% (95% CI, 2.0%-4.0%; P<0.00001) and 23.0% (95% CI, 16.0%-29.0%; P<0.00001), respectively. The incidence of dizziness/headache as the first symptom in COVID-19 patients was estimated to be 14.0% (95% CI, 8.0%-20.0%; P<0.00001). Subgroup analyses indicated that country, sex ratio, and sample size are potential influencing factors affecting the incidences of cerebrovascular disease, hypertension, and dizziness/headache. These findings suggest that cerebrovascular disease is an underlying comorbidity among patients with COVID-19. In addition, patients experiencing dizziness/headache as the first symptom of COVID-19 should receive a neurological examination.
Highlights
COVID-19 is a serious global public-health concern that has had a startling medical, economic, educational, political, and cultural impact in a number of countries [1,2,3,4]
The studies mainly reported the clinical characteristics of patients with COVID-19, incidences of underlying diseases, and prognoses
The findings suggest that country, sex ratio, and sample size are all potential influencing factors and heterogeneity sources for the constituent ratios for cerebrovascular disease, hypertension, and dizziness or headache
Summary
COVID-19 is a serious global public-health concern that has had a startling medical, economic, educational, political, and cultural impact in a number of countries [1,2,3,4]. The Americas, Europe, South-East Asia, Eastern Mediterranean, Africa, and Western Pacific have reported 9,320,330, 3,357,465, 2,072,194, 1,544,994, 788,448, and 312,771 cases, respectively (Figure 1A) [5]. The overall worldwide crude death rate among infected persons is about 3.88%, of which the crude death rates in Europe, Americas, Western Pacific, Eastern Mediterranean, South-East Asia, and Africa are about 6.34%, 3.81%, 2.68%, 2.6%, 2.17%, and 1.72%, respectively www.aging-us.com (Figure 1B) [5]. Some are single-center studies and have an insufficient sample size, low population representativeness, and limited universality of conclusions. For those reasons, this meta-analysis was performed to estimate the incidence of a history of cerebrovascular disease among patients with COVID-19
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