A network meta‐analysis of association between cardiometabolic risk factors and COVID‐19 outcome severity

Abstract

AbstractBackgroundCardiometabolic comorbidities have been associated with a higher risk of COVID‐19 severity and mortality, but more investigations are needed to determine which comorbidity is more detrimental.MethodsEmbase, Emcare, and MEDLINE were searched systematically for prospective and retrospective studies assessing the associations of cardiometabolic risk factors and COVID‐19 outcomes of hospitalization, severity, and mortality among COVID‐19‐diagnosed patients. Literature search was performed from first publication to May 19, 2021. Study quality was assessed by the Newcastle‐Ottawa Scale.ResultsFrom the literature search, 301 studies suggested that all included cardiometabolic risk factors were associated with a higher risk of COVID‐19 hospitalization, severity, and mortality, except that overweight was associated with a decreased risk of mortality (relative risk [RR] 0.88; 95% CI, 0.80–0.98). Patients with diabetes (RR 1.46; 95% CI, 1.45–1.47) were most likely to be hospitalized; patients with heart failure had the highest risk for severe COVID‐19 outcomes (RR 1.89; 95% CI, 1.71–2.09); while patients with stroke were most susceptible to overall mortality (RR 1.99; 95% CI, 1.90–2.08). In the network meta‐analysis, cerebrovascular disease had the highest impact (RR 1.69; 95% CI, 1.65–1.73) on COVID‐19 outcomes compared to other cardiometabolic risk factors. For different combinations of risk factors, cardiovascular disease and diabetes combined (RR 6.98; 95% CI, 5.28–9.22) was more detrimental than others.ConclusionsConsidering the high prevalence of cardiometabolic comorbidities and risk of all severe outcomes, patients with cardiometabolic comorbidities should be prioritized in vaccination and treatment development of COVID‐19.