Impact of Cardiovascular Risk Factors and Cardiovascular Diseases on Outcomes in Patients Hospitalized with COVID-19 in Daegu Metropolitan City

Abstract

Background: Data regarding the association between preexisting cardiovascular risk factors (CVRFs) and cardiovascular diseases (CVDs) and the outcomes of patients requiring hospitalization for coronavirus disease 2019 (COVID-19) are limited. Therefore, the aim of this study was to investigate the impact of preexisting CVRFs or CVDs on the outcomes of patients with COVID-19 hospitalized in a Korean healthcare system. Methods: Patients with COVID-19 admitted to 10 hospitals in Daegu Metropolitan City, Korea, were examined. All sequentially hospitalized patients between February 15, 2020, and April 24, 2020, were enrolled in this study. All patients were confirmed to have COVID-19 based on the positive results on the polymerase chain reaction testing of nasopharyngeal samples. Clinical outcomes during hospitalization, such as requiring intensive care and invasive mechanical ventilation (MV) and death, were evaluated. Moreover, data on baseline comorbidities such as a history of diabetes, hypertension, dyslipidemia, current smoking, heart failure, coronary artery disease, cerebrovascular accidents, and other chronic cardiac diseases were obtained. Results: Of all the patients enrolled, 954 (42.0%) had preexisting CVRFs or CVDs. Among the CVRFs, the most common were hypertension (28.8%) and diabetes mellitus (17.0%). The prevalence rates of preexisting CVRFs or CVDs increased with age (P < 0.001). The number of patients requiring intensive care (P < 0.001) and invasive MV (P < 0.001) increased with age. The in-hospital death rate increased with age (P < 0.001). Patients requiring intensive care (5.3% vs. 1.6%; P < 0.001) and invasive MV (4.3% vs. 1.7%; P < 0.001) were significantly greater in patients with preexisting CVRFs or CVDs. In-hospital mortality (12.9% vs. 3.1%; P < 0.001) was significantly higher in patients with preexisting CVRFs or CVDs. Among the CVRFs, diabetes mellitus and hypertension were associated with increased requirement of intensive care and invasive MV and in-hospital death. Among the known CVDs, coronary artery disease and congestive heart failure were associated with invasive MV and in-hospital death.

Characteristics and outcomes of patients with COVID-19 with and without prevalent hypertension: a multinational cohort study

“…Hypertension was more prevalent in hospitalised patients compared with those diagnosed with COVID-19 (range 25.6%–85.9% vs 17.4%–61.4%, respectively). The observed variability between databases is similar to previous reports, where the prevalence ranged from 28.8% 7 to 60%. 15 …”

“…To date, observational studies, [4][5][6][7][8][9][10][11][12][13][14][15][16] systematic reviews and meta-analyses have reported an increased risk of progression to severe COVID-19 and increased mortality in patients with hypertension. [17][18][19][20][21] However, these studies either only included hospitalised patients, 4-13 15 16 leading to selection bias, or had a small sample size, 6-10 15 both of which limit extrapolation of results.…”

Impact of Kidney Failure on the Severity of COVID-19

“…Meta-analysis performed among Iranian patients by Merjalili et al revealed that diabetes was associated with higher mortality, while arterial hypertension was not [ 26 ]. Park et al analyzed the Korean population and found both diabetes and hypertension to be risk factors for death in the course of COVID-19 [ 34 ]. The same results were achieved by Gupta et al among Indian patients [ 35 ].…”

COVID-19, the Pandemic of the Century and Its Impact on Cardiovascular Diseases

“…CVD and associated risk factors (adjOR = 1.79, P = 0.027), diabetes (OR = 2.43, P < 0.001), and congestive HF (OR = 2.43, P = 0.049) independently predicted in-hospital death. [ 67 ]…”