Characteristics and outcomes of severe COVID-19 in hospitalized patients with cardiovascular diseases in the Amazonian region of Brazil: a retrospective cohort

Abstract

The northern region of Brazil is already vulnerable to other infectious diseases and it was no different in COVID-19. However, cardiovascular diseases still lead the causes of death. Thus, the objective of this study is to identify the clinical predictors and outcome of severe COVID-19 in hospitalized patients with and without CVD in this region of the Amazon. A retrospective cohort, referring to the notifications from January 1 to December 31, 2020, including cases confirmed by molecular testing. The study consisted of 9223 confirmed cases for COVID-19. Of these, 6011 (65.17%) did not have cardiovascular disease and 3212 (34.83%) had some cardiovascular disease. The significance of deaths was in the age group of < 1 to 59 CVD carriers (< 0.001). Predictor of mortality were invasive ventilation for patients with CVD, (OR 23,688 CI 18,180–30,866), followed by chronic kidney disease (OR 2442 CI 1568–3740), dyspnea (OR 2312 CI 1817–3941), respiratory distress (OR 1523 CI 1210–2919), cough (OR 1268 CI 1005–1599), Lower oxygen saturation 95% (OR 1281 CI 1039–1579), diabetes mellitus (OR 1267 CI 1050–1528) and age (OR 1051 CI 1044–1058). Carriers of CVD had a lower survival rate (< 0.0001). The order of the predictors of death differed among the non-carriers, as well as the high odds ratio in the predictors of CVD, only cough was an independent predictor. The age group under 59 years was associated with deaths. We also show the shorter survival in CVD carriers, as well as the higher cardiovascular morbidity rate than other studies in the literature.

Clinical Characteristics and Outcomes among Vaccinated and Unvaccinated Patients with Cardiovascular Disease Who Were Hospitalized for COVID-19 in Brazil: Retrospective Cohort

“…Additionally, we highlighted the predictors of death associated with CVD patients, which were similar to non-carriers. However, the odds ratio in CVD was higher, as well as the significance in deaths < 59 years in CVD patients and cough as an independent factor, which still showed a lethality 55.5% higher than other studies in the literature and our results [26]. We know that this region is already vulnerable due to local factors, including environmental factors, indigenous peoples, and environmental contamination by mercury [51][52][53].…”

“…Some studies in the world have already analyzed severe COVID-19 in patients with cardiovascular disease [22][23][24][25]. Additionally, in Brazil, only one cohort study was conducted in the north of the country in the first year of the pandemic, which occurred before vaccination, and this showed what the predictors of death in CVD patients and non-carriers were [26].…”

Single cell RNA-seq resolution revealed CCR1+/SELL+/XAF+ CD14 monocytes mediated vascular endothelial cell injuries in Kawasaki disease and COVID-19

“…Since the initial outbreak in late 2019, COVID-19 has been considered the most dominant healthy challenge across the world [1] . Cardiovascular complications have been reported to be associated with increased mortality and worsening hospital outcomes [2] . The infection between SARS-Cov-2 and host cells relies on several receptors binding with Spike glycoprotein (S protein), including angiotensin-converting enzyme 2 (ACE2) [3] .…”