Association Between Cardiovascular Risk Factors and the Severity of Coronavirus Disease 2019: Nationwide Epidemiological Study in Korea

Abstract

Background: Acute respiratory viral infections can result in cardiovascular involvement, with such patients having a significantly higher mortality rate than those without cardiovascular involvement. Due to the ongoing coronavirus disease 2019 (COVID-19) pandemic, it is important to determine whether cardiovascular risk factors are associated with the severity of COVID-19.Methods: These nationwide data were provided by the Korea Disease Control and Prevention Agency. We defined a patient as having a “critical illness” if they required more than invasive mechanical ventilation and “fatal illness” if they died.Results: Among the total 5,307 patients, 2,136 (40.8%) were male. The critical illness rate was 5.1% (males: 6.7, females: 4.0%) and the fatality rate was 4.54%. The multivariable analysis showed that age ≥60 years, male sex, diabetes mellitus, hypertension, heart failure, chronic kidney disease, cancer, and dementia were independent risk factors for critical illness. The risk scoring model showed the significance of multiple risk factors. Patients with four risk factors; old age (≥60 years), male sex, hypertension, and diabetes mellitus had a more than a 100 times higher risk for severe COVID-19 than those without these risk factors (OR; 95% confidence interval, 104; 45.6–240.6 for critical, 136.2; 52.3–3547.9 for fatal illness).Conclusions: This study demonstrated that cardiovascular risk factors are also significant risk factors for severe COVID-19. In particular, patients who have multiple cardiovascular risk factors are more likely to progress to severe COVID-19. Therefore, early and appropriate treatment of these patients is crucial.

Using Machine Learning to Detect Theranostic Biomarkers Predicting Respiratory Treatment Response

“…The link between liver disease and CVD and diabetes and CVD has been confirmed in previous studies [ 22 , 23 ]. Recent studies have also demonstrated the association between CVD, liver disease, diabetes, and respiratory viral infections (e.g., COPD and COVID-19) [ 24 , 25 , 26 ]. Therefore, our findings are consistent with previous studies suggesting that people at risk of CVD, liver disease, or diabetes are also at risk of respiratory infections and therefore can be treated similarly.…”

Cardiovascular Health Care Implications of the COVID-19 pandemic

“…In a meta-analysis of 51 studies including a total of 48,317 patients, Bae et al 10 identified pre-existing cardiovascular risk factors (hypertension, diabetes) and CVD itself as independent predictors of mortality amongst patients with COVID-19 across all age groups. A large nationwide study from Korea similarly reports significant associations of diabetes, hypertension, and heart failure with critical illness amongst patients hospitalised with COVID-19 11 . Accordingly, Wu et al 13 report an 8% increase in acute cardiovascular deaths in England during the pandemic period.…”

“…The COVID-19 pandemic has resulted in excess premature mortality across many countries worldwide 8 , 9 . Cardiovascular disease and its risk factors have been linked to higher risk of adverse COVID-19 outcomes, including more severe disease manifestations and higher risk of death 10 , 11 , 12 . In a meta-analysis of 51 studies including a total of 48,317 patients, Bae et al 10 identified pre-existing cardiovascular risk factors (hypertension, diabetes) and CVD itself as independent predictors of mortality amongst patients with COVID-19 across all age groups.…”

Gene Variants Related to Cardiovascular and Pulmonary Diseases May Correlate with Severe Outcome of COVID-19

“…For instance, a cohort study from China showed that the fatality rate among patients with CVD was 10.5% [ 6 ]. Moreover, the epidemiological study and meta-analyses indicated that cardiovascular diseases (such as heart failure or chronic stable heart disease) were significant risk factors for severe COVID-19 [ 7 , 8 ]. Studies on the influence of respiratory diseases, such as asthma and chronic obstructive lung disease, showed more inconsistencies in the impact of pre-existing PD on the severe COVID-19 course [ 8 , 9 ].…”