TY - JOUR
T1 - Impact of the COVID-19 pandemic on in-hospital mortality in cardiovascular disease
T2 - a meta-analysis
AU - Cannata, Antonio
AU - Watson, Samuel A.
AU - Daniel, Allen
AU - Giacca, Mauro
AU - Shah, Ajay M.
AU - McDonagh, Theresa A.
AU - Scott, Paul A.
AU - Bromage, Daniel I.
N1 - Publisher Copyright:
VC The Author(s) 2021.
PY - 2022/5/27
Y1 - 2022/5/27
N2 - Aims The COVID-19 pandemic has resulted in excess mortality due to both COVID-19 directly and other conditions, including cardiovascular (CV) disease. We aimed to explore the excess in-hospital mortality, unrelated to COVID-19 infection, across a range of CV diseases. Methods and A systematic search was performed for studies investigating in-hospital mortality among patients admitted with CV results disease without SARS-CoV-2 infection compared with a period outside the COVID-19 pandemic. Fifteen studies on 27 421 patients with CV disease were included in the analysis. The average in-hospital mortality rate was 10.4% (n = 974) in the COVID-19 group and 5.7% (n = 1026) in the comparator group. Compared with periods outside the COVID-19 pandemic, the pooled risk ratio (RR) demonstrated increased in-hospital mortality by 62% during COVID-19 [95% confidence interval (CI) 1.20–2.20, P = 0.002]. Studies with a decline in admission rate >50% during the COVID-19 pandemic observed the greatest increase in mortality compared with those with <50% reduction [RR 2.74 (95% CI 2.43–3.10) vs. 1.21 (95% CI 1.07–1.37), P < 0.001]. The observed increased mortality was consistent across different CV conditions (P = 0.74 for interaction). Conclusions In-hospital mortality among patients admitted with CV diseases was increased relative to periods outside the pandemic, independent of co-infection with COVID-19. This effect was larger in studies with the biggest decline in admission rates, suggesting a sicker cohort of patients in this period. However, studies were generally poorly conducted, and there is a need for further well-designed studies to establish the full extent of mortality not directly related to COVID-19 infection.
AB - Aims The COVID-19 pandemic has resulted in excess mortality due to both COVID-19 directly and other conditions, including cardiovascular (CV) disease. We aimed to explore the excess in-hospital mortality, unrelated to COVID-19 infection, across a range of CV diseases. Methods and A systematic search was performed for studies investigating in-hospital mortality among patients admitted with CV results disease without SARS-CoV-2 infection compared with a period outside the COVID-19 pandemic. Fifteen studies on 27 421 patients with CV disease were included in the analysis. The average in-hospital mortality rate was 10.4% (n = 974) in the COVID-19 group and 5.7% (n = 1026) in the comparator group. Compared with periods outside the COVID-19 pandemic, the pooled risk ratio (RR) demonstrated increased in-hospital mortality by 62% during COVID-19 [95% confidence interval (CI) 1.20–2.20, P = 0.002]. Studies with a decline in admission rate >50% during the COVID-19 pandemic observed the greatest increase in mortality compared with those with <50% reduction [RR 2.74 (95% CI 2.43–3.10) vs. 1.21 (95% CI 1.07–1.37), P < 0.001]. The observed increased mortality was consistent across different CV conditions (P = 0.74 for interaction). Conclusions In-hospital mortality among patients admitted with CV diseases was increased relative to periods outside the pandemic, independent of co-infection with COVID-19. This effect was larger in studies with the biggest decline in admission rates, suggesting a sicker cohort of patients in this period. However, studies were generally poorly conducted, and there is a need for further well-designed studies to establish the full extent of mortality not directly related to COVID-19 infection.
KW - Cardiovascular disease
KW - COVID-19
KW - In-hospital mortality
KW - Meta-analysis
UR - http://www.scopus.com/inward/record.url?scp=85131221420&partnerID=8YFLogxK
U2 - 10.1093/eurjpc/zwab119
DO - 10.1093/eurjpc/zwab119
M3 - Article
C2 - 34297822
AN - SCOPUS:85131221420
SN - 2047-4881
VL - 29
SP - 1266
EP - 1274
JO - European journal of preventive cardiology
JF - European journal of preventive cardiology
IS - 8
ER -