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We aim to systematically explore the association of COVID\u201019 severity and mortality rate with the history of cardiovascular diseases and\/or other comorbidities and cardiac injury laboratory markers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The standardized mean difference (SMD) or odds ratio (OR) and 95% confidence intervals (CIs) were applied to estimate pooled results from the 56 studies. The prognostic performance of cardiac markers for predicting adverse outcomes and to select the best cutoff threshold was estimated by receiver operating characteristic curve analysis. Decision tree analysis by combining cardiac markers with demographic and clinical features was applied to predict mortality and severity in patients with COVID\u201019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A meta\u2010analysis of 17\u2009794 patients showed patients with high cardiac troponin I (OR\u2009=\u20095.22, 95% CI\u2009=\u20093.73\u20107.31, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and aspartate aminotransferase (AST) levels (OR\u2009=\u20093.64, 95% CI\u2009=\u20092.84\u20104.66, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) were more likely to develop adverse outcomes. High troponin I more than 13.75\u2009ng\/L combined with either advanced age more than 60 years or elevated AST level more than 27.72\u2009U\/L was the best model to predict poor outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>COVID\u201019 severity and mortality are complicated by myocardial injury. Assessment of cardiac injury biomarkers may improve the identification of those patients at the highest risk and potentially lead to improved therapeutic approaches.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmv.26166","type":"journal-article","created":{"date-parts":[[2020,6,12]],"date-time":"2020-06-12T14:13:13Z","timestamp":1591971193000},"page":"2473-2488","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":87,"title":["Association of cardiac biomarkers and comorbidities with increased mortality, severity, and cardiac injury in COVID\u201019 patients: A meta\u2010regression and decision tree analysis"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9267-3787","authenticated-orcid":false,"given":"Eman A.","family":"Toraih","sequence":"first","affiliation":[{"name":"Department of Surgery, School of Medicine Tulane University New Orleans LA"},{"name":"Department of Histology and Cell Biology, Genetics Unit, Faculty of Medicine Suez Canal University Ismailia Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3381-2641","authenticated-orcid":false,"given":"Rami M.","family":"Elshazli","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Genetics, Faculty of Physical Therapy Horus University \u2010 Egypt New Damietta Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8278-7094","authenticated-orcid":false,"given":"Mohammad H.","family":"Hussein","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine Tulane University New Orleans LA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6790-5849","authenticated-orcid":false,"given":"Abdelaziz","family":"Elgaml","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Pharmacy Mansoura University Mansoura Egypt"},{"name":"Department of Microbiology and Immunology, Faculty of Pharmacy Horus University \u2010 Egypt New Damietta Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8167-2356","authenticated-orcid":false,"given":"Mohamed","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Faculty of Pharmacy Mansoura University Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4375-5724","authenticated-orcid":false,"given":"Mohammed","family":"El\u2010Mowafy","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Pharmacy Mansoura University Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2649-3002","authenticated-orcid":false,"given":"Mohamed","family":"El\u2010Mesery","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Faculty of Pharmacy Mansoura University Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assem","family":"Ellythy","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine Tulane University New Orleans LA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1490-1585","authenticated-orcid":false,"given":"Juan","family":"Duchesne","sequence":"additional","affiliation":[{"name":"Department of Surgery, Trauma\/Acute Care and Critical Care Tulane School of Medicine New Orleans LA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3546-6946","authenticated-orcid":false,"given":"Mary T.","family":"Killackey","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine Tulane University New Orleans LA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3338-4410","authenticated-orcid":false,"given":"Keith C.","family":"Ferdinand","sequence":"additional","affiliation":[{"name":"John W. 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