Cardiac Complications and Pertaining Mortality Ratein COVID-19 Patients; a Systematic Review and Meta-Analysis

Raising knowledge over cardiac complications and managing them can play a key role in theirrecovery. In this study, we aim to investigate the evidence regarding the prevalence of cardiac complicationsand the resulting mortality rate in COVID-19 patients.

Search was conducted in electronic databasesof Medline (using PubMed), Embase, Scopus, and Web of Science, in addition to the manual search in preprintdatabases, and Google and Google scholar search engines, for articles published from 2019 until April 30th,2020. Inclusion criterion was reviewing and reporting cardiac complications in patients with confirmed COVID-19.

The initial search resulted in 853 records, out of which 40 articles were included. Overall analysisshowed that the prevalence of acute cardiac injury, heart failure and cardiac arrest were 19.46% (95% CI: 18.23-20.72), 19.07% (95% CI: 15.38-23.04) and 3.44% (95% CI: 3.08-3.82), respectively. Moreover, abnormal serumtroponin level was observed in 22.86% (95% CI: 21.19-24.56) of the COVID-19 patients. Further analysis revealedthat the overall odds of mortality is 14.24 (95% CI: 8.67-23.38) times higher when patients develop acute car-diac injury. The pooled odds ratio of mortality when the analysis was limited to abnormal serum troponin levelwas 19.03 (95% CI: 11.85-30.56).

Acute cardiac injury and abnormal serum troponin level were themost prevalent cardiac complications/abnormalities in COVID-19 patients. The importance of cardiac compli-cations is emphasized due to the higher mortality rate among patients with these complications. Thus, troponinscreenings and cardiac evaluations are recommended to be performed in routine patient assessments.