Cardiovascular Disease, Intensive Care, and Mortality in Coronavirus Disease 2019 Patients: A Meta-Analysis

Objective: Coronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus-2. The coronavirus disease 2019 pandemic has imparted an extraordinary burden on the intensive care services, which is likely to echo in pandemic and critical care management globally. We aim to meta-analyze mortality outcomes in cardiovascular disease patients and groups receiving corticosteroids therapy, intensive care admission status during coronavirus disease 2019 hospitalization and groups receiving corticosteroid therapy, and lastly, mortality outcomes in mechanically ventilated patients. Finally we collate a coronavirus disease 2019 field algorithm for ST-elevation myocardial infarction critical care. Methods: PubMed databases were searched for relevant observational studies with MeSH terms including, "cardiovascular disease," "COVID-19," "intensive care," "mortality," and "mechanical ventilation." A random-effect model was used to calculate the risk ratio, using RevMan V5.3. Results: A total of 67 622 patients were included with 10 076 participants in the cardiovascular disease group. Overall, the mean age of the participants in the studies was 60 +/- 1.6 years and 52.1% were female. A higher death risk was found in cardiovascular disease patients during and after coronavirus disease 2019 infection (risk ratio =2.43, 95% CI =1.74 to 3.41, P< .0001;. Mechanical ventilation was likened to worsen mortality rates at any time during the hospital stay (risk ratio = 5.32, 95% CI = 3.89 to 7.29, P < .0001). Publication bias was not observed and high methodological qualities were included. Conclusions: Cardiovascular disease imparts a high burden on intensive care leading to high mortality among coronavirus disease 2019 patients. It is essential that myocardial infarctions in the acute care setting, and conditions such as hypertension and coronary artery diseases, are closely monitored while leading coronavirus disease 2019 hospitalization protocols.