Clinical Characteristics and Outcomes of COVID-19 Positive Acute Coronary Syndrome Patients; a multisource Electronic Healthcare Records Study from England

Rashid, Muhammad; Wu, Jianhua; Curzen, Nick; Zaman, Azfar; Clarke, Sarah; Nolan, Jim; Shoiab, Ambreen; Mohamed, Mohamed; M, De Belder; Deanfield, John; Gale, Chris P; Mamas, Mamas A.

doi:10.1101/2020.08.20.20175091

Cited by 2 publications

(1 citation statement)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Higher rates of hypertension, hyperlipidemia, diabetes mellitus, heart failure, and chronic kidney disease all may contribute to an elevated risk of major adverse cardiovascular events in COVID-19 ACS patients, consistent with other recent cohorts ( 25 ). However, our data suggest that these factors did not play a major role, because correcting for them still resulted in excess mortality.…”

Section: Discussionsupporting

confidence: 87%

International Prospective Registry of Acute Coronary Syndromes in Patients With COVID-19

Kite

Ludman

Gale

et al. 2021

Journal of the American College of Cardiology

Self Cite

View full text Add to dashboard Cite

Background Published data suggest worse outcomes in acute coronary syndrome (ACS) patients and concurrent coronavirus disease 2019 (COVID-19) infection. Mechanisms remain unclear. Objectives The purpose of this study was to report the demographics, angiographic findings, and in-hospital outcomes of COVID-19 ACS patients and compare these with pre–COVID-19 cohorts. Methods From March 1, 2020 to July 31, 2020, data from 55 international centers were entered into a prospective, COVID-ACS Registry. Patients were COVID-19 positive (or had a high index of clinical suspicion) and underwent invasive coronary angiography for suspected ACS. Outcomes were in-hospital major cardiovascular events (all-cause mortality, re–myocardial infarction, heart failure, stroke, unplanned revascularization, or stent thrombosis). Results were compared with national pre–COVID-19 databases (MINAP [Myocardial Ischaemia National Audit Project] 2019 and BCIS [British Cardiovascular Intervention Society] 2018 to 2019). Results In 144 ST-segment elevation myocardial infarction (STEMI) and 121 non–ST-segment elevation acute coronary syndrome (NSTE-ACS) patients, symptom-to-admission times were significantly prolonged (COVID-STEMI vs. BCIS: median 339.0 min vs. 173.0 min; p < 0.001; COVID NSTE-ACS vs. MINAP: 417.0 min vs. 295.0 min; p = 0.012). Mortality in COVID-ACS patients was significantly higher than BCIS/MINAP control subjects in both subgroups (COVID-STEMI: 22.9% vs. 5.7%; p < 0.001; COVID NSTE-ACS: 6.6% vs. 1.2%; p < 0.001), which remained following multivariate propensity analysis adjusting for comorbidities (STEMI subgroup odds ratio: 3.33 [95% confidence interval: 2.04 to 5.42]). Cardiogenic shock occurred in 20.1% of COVID-STEMI patients versus 8.7% of BCIS patients (p < 0.001). Conclusions In this multicenter international registry, COVID-19–positive ACS patients presented later and had increased in-hospital mortality compared with a pre–COVID-19 ACS population. Excessive rates of and mortality from cardiogenic shock were major contributors to the worse outcomes in COVID-19 positive STEMI patients.

show abstract

Section: Discussionsupporting

confidence: 87%

International Prospective Registry of Acute Coronary Syndromes in Patients With COVID-19

Kite

Ludman

Gale

et al. 2021

Journal of the American College of Cardiology

Self Cite

View full text Add to dashboard Cite

show abstract

The association of smoking status with SARS‐CoV‐2 infection, hospitalization and mortality from COVID‐19: a living rapid evidence review with Bayesian meta‐analyses (version 7)

et al. 2020

View full text Add to dashboard Cite

Aims To estimate the association of smoking status with rates of i) infection, ii) hospitalisation, iii) disease severity, and iv) mortality from SARS‐CoV‐2/COVID‐19 disease. Design Living rapid review of observational and experimental studies with random‐effects hierarchical Bayesian meta‐analyses. Published articles and pre‐prints were identified via MEDLINE and medRxiv. Setting Community or hospital. No restrictions on location. Participants Adults who received a SARS‐CoV‐2 test or a COVID‐19 diagnosis. Measurements Outcomes were SARS‐CoV‐2 infection, hospitalisation, disease severity and mortality stratified by smoking status. Study quality was assessed (i.e. ‘good’, ‘fair’ and ‘poor’). Findings Version 7 (searches up to 25 August 2020) included 233 studies with 32 ‘good’ and ‘fair’ quality studies included in meta‐analyses. Fifty‐seven studies (24.5%) reported current, former and never smoking status. Recorded smoking prevalence among people with COVID‐19 was generally lower than national prevalence. Current compared with never smokers were at reduced risk of SARS‐CoV‐2 infection (RR=0.74, 95% Credible Interval (CrI) = 0.58‐0.93, τ = 0.41). Data for former smokers were inconclusive (RR=1.05, 95% CrI = 0.95‐1.17, τ = 0.17) but favoured there being no important association (21% probability of RR ≥1.1). Former compared with never smokers were at somewhat increased risk of hospitalisation (RR=1.20, CrI = 1.03‐1.44, τ = 0.17), greater disease severity (RR=1.52, CrI = 1.13‐2.07, τ = 0.29), and mortality (RR=1.39, 95% CrI = 1.09‐1.87, τ = 0.27). Data for current smokers were inconclusive (RR=1.06, CrI = 0.82‐1.35, τ = 0.27; RR=1.25, CrI = 0.85‐1.93, τ = 0.34; RR=1.22, 95% CrI = 0.78‐1.94, τ = 0.49 respectively) but favoured there being no important associations with hospitalisation and mortality (35% and 70% probability of RR ≥1.1, respectively) and a small but important association with disease severity (79% probability of RR ≥1.1). Conclusions Compared with never smokers, current smokers appear to be at reduced risk of SARS‐CoV‐2 infection while former smokers appear to be at increased risk of hospitalisation, increased disease severity and mortality from COVID‐19. However, it is uncertain whether these associations are causal.

show abstract

Clinical Characteristics and Outcomes of COVID-19 Positive Acute Coronary Syndrome Patients; a multisource Electronic Healthcare Records Study from England

Cited by 2 publications

References 32 publications

International Prospective Registry of Acute Coronary Syndromes in Patients With COVID-19

International Prospective Registry of Acute Coronary Syndromes in Patients With COVID-19

The association of smoking status with SARS‐CoV‐2 infection, hospitalization and mortality from COVID‐19: a living rapid evidence review with Bayesian meta‐analyses (version 7)

Contact Info

Product

Resources

About