Peripheral artery disease independently associated with significantly higher risk for COVID-19 mortality: Evidence based on adjusted effect estimates

Abstract

Objective To investigate the influence of peripheral artery disease (PAD) on the risk of mortality among coronavirus disease 2019 (COVID-19) patients based on adjusted effect estimates. Methods Systematic searches were performed through electronic databases. A random-effect model was applied to calculate the pooled effect and corresponding 95% confidence interval (CI). Inconsistency index (I2) was used to evaluate the heterogeneity across studies. Sensitivity analysis, subgroup analysis, and Begg’s test were all implemented. Results On the basis of 16 eligible studies with 142,832 COVID-19 patients, the meta-analysis showed that PAD significantly increased the risk for mortality among COVID-19 patients (pooled effect = 1.29, 95% CI: 1.10–1.51). The significant association was also observed in the subgroup analysis stratified by hospitalized patients, mean age ≥ 60 years, Europe and North America. Sensitivity analysis verified the robustness of our findings. Begg’s test ( P = 0.15) showed there was no potential publication bias. Conclusions COVID-19 patients with PAD may have a greater risk of mortality. Clinicians and nursing staff are supposed to identify and monitor these high-risk patients in a timely manner and provide appropriate clinical treatment for them.