• Mehrdad Sahranavard, Arash Akhavan Rezayat, Mohammad Zamiri Bidary, Alireza Omranzadeh, Farahnaz Rohani, Ramin Hamidi Farahani, Ebrahim Hazrati, Seyyed Hossein Mousavi, Mohamed Afshar Ardalan, Saeed Soleiman-Meigooni, Seyyed-Javad Hosseini-Shokouh, Zia Hejripour, Ehsan Nassireslami, Reza Laripour, Amirahmad Salarian, Abbas Nourmohammadi, and Reza Mosaed.
• Student Research Committee, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
• Arch Iran Med. 2021 Feb 1; 24 (2): 152-163.

BackgroundThe 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.MethodsA 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.ResultsOut 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).ConclusionCOVID-19 can affect different parts of the heart; however, the myocardium is more involved.© 2021 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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