Description
- Abstract:
- Importance: Cardiometabolic comorbidities have been associated with a higher risk of COVID-19 severity and mortality and are prevalent among COVID-19 patients. Objective: Synthesize evidence regarding cardiometabolic risk factors for COVID-19 outcome severity using a network analysis. Data Sources: Embase 1910, Ovid Emcare 1995, and MEDLINE® 1946 to May 19, 2021 were searched for prospective and retrospective studies related to cardiometabolic risk factors when infected by COVID-19. English and Chinese studies were included. Study Selection: Search criteria were on primary studies on cardiometabolic risk factors among COVID-19 diagnosed patients. Studies with insufficient data were excluded. Initially, 6,081 studies were identified, and 146 studies qualified from early pandemic timeframe up to July 28, 2020. Additional 20,580 were screened and finalized as 181 studies from July 29, 2020 to May 19, 2021. Data Extraction and Synthesis: Two investigators who performed literature screening, extracted data separately, and pooled data using a fixed-effect model. The assessment of literature quality was performed independently following the Newcastle-Ottawa Scale (NOS). Main Outcome(s) and Measure(s): Before data collection, a hypothesis of greater risk and increasing severity between cardiometabolic risk and all COVID-19 outcomes was formulated. Study outcomes were hospitalization, severe outcomes of COVID-19, and mortality. Results: During first year of pandemic, the presence of all cardiometabolic risk factors except for myocardial infarction were associated with a higher risk of risk of disease severity. Patients with heart failure (OR 2.73, 95% CI: 2.37 to 3.16) and overweight status (OR 1.89, 95% CI: 1.46 to 2.45) had greatest association with severe outcomes. During recent pandemic, patients with diabetes (OR 1.46, 95% CI: 1.45 to 1.47) were most likely to be hospitalized, and obese patients had highest risk for severe COVID-19 outcomes. Network analysis for any COVID-19 outcome was led by cerebrovascular disease as an individual risk factor at 1.69 (95% CI: 1.65 to 1.73) and CVD and DM combined (OR 6.98, 95% CI: 5.28 to 9.22). Conclusions and Relevance: By accounting for heterogeneity, this meta-analysis and network analysis strengthened existing evidence on increased risk of COVID-19 hospitalization, severity, and mortality among those with cardiometabolic comorbidities. Considering the high prevalence of cardiometabolic comorbidities and risk of all severe outcomes, patients with cardiometabolic should be prioritized in vaccination and treatment development of COVID-19.
- Notes:
- Thesis (M. P. H.)--Brown University, 2021
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Citation
Li, Alina Binbin,
"A network meta-analysis assessing the association between cardiometabolic risk factors and coronavirus disease 2019 (COVID-19) -related outcomes"
(2021).
Public Health Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://repository.library.brown.edu/studio/item/bdr:4rfvtmwk/
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Public Health Theses and Dissertations
Theses and Dissertations for the Public Health department....