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

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 (I-2) 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.