Mehrdad Sahranavard
1 
, Arash Akhavan Rezayat
2,3, Mohammad Zamiri Bidary
3, Alireza Omranzadeh
3, Farahnaz Rohani
3, Ramin Hamidi Farahani
2, Ebrahim Hazrati
4, Seyyed Hossein Mousavi
5, Mohamed Afshar Ardalan
6, Saeed Soleiman-Meigooni
2, Seyyed-Javad Hosseini-Shokouh
2, Zia Hejripour
7, Ehsan Nassireslami
8,9, Reza Laripour
10,11, Amirahmad Salarian
8, Abbas Nourmohammadi
12, Reza Mosaed
13,14* 1 Student Research Committee, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Infectious Disease Research Center, AJA University of Medical Sciences, Tehran, Iran
3 Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4 Department Anesthesiology and Critical Care, AJA University of Medical Sciences, Tehran, Iran
5 Department of Cardiology, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
6 Internal Medicine Department, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
7 Department of Emergency Medicine, AJA University of Medical Sciences, Tehran, Iran
8 Toxin Research center, AJA University of Medical Sciences, Tehran, Iran
9 Department of Pharmacology and Toxicology, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
10 Education Development Center, AJA University of Medical Sciences, Tehran, Iran
11 Center for Educational Research in Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
12 Faculty of Aerospace and Diving Medicine, AJA University of Medical Sciences, Tehran, Iran
13 Department of Clinical Pharmacy, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
14 Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Background: The newly emerged coronavirus disease 2019 (COVID-19) seems to involve different organs, including the cardiovascular system. We systematically reviewed COVID-19 cardiac complications and calculated their pooled incidences. Secondarily, we compared the cardiac troponin I (cTnI) level between the surviving and expired patients.
Methods: A systematic search was conducted for manuscripts published from December 1, 2019 to April 16, 2020. Cardiovascular complications, along with the levels of cTnI, creatine kinase (CK), and creatine kinase MB (CK-MB) in hospitalized PCR-confirmed COVID-19 patients were extracted. The pooled incidences of the extracted data were calculated, and the unadjusted cTnI level was compared between the surviving and expired patients.
Results: Out of 1094 obtained records, 22 studies on a total of 4,157 patients were included. The pooled incidence rate of arrhythmia was 10.11%. Furthermore, myocardial injury had a pooled incidence of 17.85%, and finally, the pooled incidence for heart failure was 22.34%. The pooled incidence rates of cTnI, CK-MB, and CK elevations were also reported at 15.16%, 10.92%, and 12.99%, respectively. Moreover, the pooled level of unadjusted cTnI was significantly higher in expired cases compared with the surviving (mean difference = 31.818, 95% CI = 17.923-45.713, P value <0.001).
Conclusion: COVID-19 can affect different parts of the heart; however, the myocardium is more involved.