Abstract:COVID-19 pandemic, a global health disaster, has resulted in substantial morbidity and mortality across the globe since emerging on December 2019. Studies have shown that cardiovascular manifestations and complications linked to COVID-19 can be attributed to unfavorable clinical outcome and poor prognosis. Adult patients with laboratory-confirmed COVID-19 requiring hospitalization in participating centers between March and June 2020 were included. Data including demographics, laboratory findings, comorbidities… Show more
“…The estimated 30-day survival probability for a profile patient with pre-existing CHD (65-year-old woman with no other comorbidities) was 0.5 (95% CI 0.3-0.8). Furthermore, a study in Oman [27] found that patients with cardiac injury had higher mortality than those without cardiac injury (53.3% vs 7.1%). The literature review by de Almeida-Pittito [13] mentioned above also suggested that cardiovascular disease was strongly associated with both severity and mortality, respectively (OR 4.0 95% CI 2.8-5.9 and OR 6.3 95% CI 3.7-10.8) also reflecting the previous findings [10].…”
Section: Covid-19 and Hypertension/cardiovascular Diseasesmentioning
Background
Since early 2020, the Covid-19 pandemic has engulfed the world. Amidst the growing number of infections and deaths, there has been an emphasis of patients with non-communicable diseases as they are particularly susceptible to the virus. The objective of this literature review is to systematize the available evidence on the link between non-communicable diseases and Covid-19.
Methods
We have conducted a systematic review of the literature on Covid-19 and non-communicable diseases from December, 2019 until 15th of November, 2020. The search was done in PubMed and in doing so we used a variety of searching terms in order to isolate the final set of papers. At the end of the selection process, 45 papers were selected for inclusion in the literature review.
Results
The results from the review indicate that patients with certain chronic illnesses such as diabetes, hypertension (and other cardiovascular diseases), chronic respiratory illnesses, chronic kidney and liver conditions are more likely to be affected by Covid-19. More importantly, once they do get infected by the virus, patients with chronic illnesses have a much higher likelihood of having worse clinical outcomes (developing a more severe form of the disease or dying) than an average patient. There are two hypothesized channels that explain this strong link between the chronic illnesses enumerated above and Covid 19: (i) increased ACE2 (angiotensin-converting enzyme 2) receptor expressions, which facilitates the entry of the virus into the host body; and (ii) hyperinflammatory response, referred to as “cytokine storm”. Finally, the literature review does not find any evidence that diabetes or hypertension related medications exacerbate the overall Covid-19 condition in chronic illness patients.
Conclusions
Thus, the evidence points out to ‘business as usual’ disease management model, although with greater supervision. However, given the ongoing Covid-19 vulnerabilities among people with NCDs, prioritizing them for the vaccination process should also figure high on the agenda on health authorities.
“…The estimated 30-day survival probability for a profile patient with pre-existing CHD (65-year-old woman with no other comorbidities) was 0.5 (95% CI 0.3-0.8). Furthermore, a study in Oman [27] found that patients with cardiac injury had higher mortality than those without cardiac injury (53.3% vs 7.1%). The literature review by de Almeida-Pittito [13] mentioned above also suggested that cardiovascular disease was strongly associated with both severity and mortality, respectively (OR 4.0 95% CI 2.8-5.9 and OR 6.3 95% CI 3.7-10.8) also reflecting the previous findings [10].…”
Section: Covid-19 and Hypertension/cardiovascular Diseasesmentioning
Background
Since early 2020, the Covid-19 pandemic has engulfed the world. Amidst the growing number of infections and deaths, there has been an emphasis of patients with non-communicable diseases as they are particularly susceptible to the virus. The objective of this literature review is to systematize the available evidence on the link between non-communicable diseases and Covid-19.
Methods
We have conducted a systematic review of the literature on Covid-19 and non-communicable diseases from December, 2019 until 15th of November, 2020. The search was done in PubMed and in doing so we used a variety of searching terms in order to isolate the final set of papers. At the end of the selection process, 45 papers were selected for inclusion in the literature review.
Results
The results from the review indicate that patients with certain chronic illnesses such as diabetes, hypertension (and other cardiovascular diseases), chronic respiratory illnesses, chronic kidney and liver conditions are more likely to be affected by Covid-19. More importantly, once they do get infected by the virus, patients with chronic illnesses have a much higher likelihood of having worse clinical outcomes (developing a more severe form of the disease or dying) than an average patient. There are two hypothesized channels that explain this strong link between the chronic illnesses enumerated above and Covid 19: (i) increased ACE2 (angiotensin-converting enzyme 2) receptor expressions, which facilitates the entry of the virus into the host body; and (ii) hyperinflammatory response, referred to as “cytokine storm”. Finally, the literature review does not find any evidence that diabetes or hypertension related medications exacerbate the overall Covid-19 condition in chronic illness patients.
Conclusions
Thus, the evidence points out to ‘business as usual’ disease management model, although with greater supervision. However, given the ongoing Covid-19 vulnerabilities among people with NCDs, prioritizing them for the vaccination process should also figure high on the agenda on health authorities.
Background
With the continuance of the global COVID-19 pandemic, cardiovascular disease (CVD) and cardiac injury have been suggested to be risk factors for severe COVID-19.
Objective
The aim is to evaluate the mortality risks associated with CVD and cardiac injury among hospitalized COVID-19 patients, especially in subgroups of populations in different countries.
Methods
A comprehensive systematic literature search was performed using 9 databases from November 1, 2019 to November 9, 2020. Meta-analyses were performed for CVD and cardiac injury between non-survivors and survivors of COVID-19.
Results
Although the prevalence of CVD in different populations was different, hospitalized COVID-19 patients with CVD were at a higher risk of fatal outcomes (OR = 2.72; 95% CI 2.35–3.16) than those without CVD. Separate meta-analyses of populations in four different countries also reached a similar conclusion that CVD was associated with an increase in mortality. Cardiac injury was common among hospitalized COVID-19 patients. Patients with cardiac injury had a significantly higher mortality risk than those without cardiac injury (OR = 13.25; 95% CI: 8.56–20.52).
Conclusions
Patients' CVD history and biomarkers of cardiac injury should be taken into consideration during the hospital stay and incorporated into the routine laboratory panel for COVID-19.
“…Another study reported 21.7% cardiac injury incidence and identified age, hypertension, chronic heart failure, diabetes, chronic obstructive pulmonary disease/asthma as risk factors for cardiac injury in COVID-19. Outcomes for patients with cardiovascular injuries were worse including increased incidence of mechanical ventilation, acute respiratory distress syndrome, acute kidney injury, anemia and death 20 . An international, multicenter cohort study including 7 hospitals consisting of 305 hospitalized COVID-19 patients in New York City and Milan found myocardial injury was observed in 62.3% of patients.…”
Objective
To analyze outcomes and risk factors of cardiovascular events in a metropolitan COVID-19 database, and to perform a subgroup analysis in African American populations to determine whether outcomes and risk factors are influenced by race.
Design
Retrospective cohort analysis from March 9, 2020 to June 20, 2020.
Setting
Population-based study in Louisville, KY, USA
Participants
700 adult inpatients hospitalized with COVID-19.
Interventions
N/A
Measurements and Main
Results: Our cohort consisted of 126 patients (18%) with cardiovascular events and 574 patients without cardiovascular events. Patients with cardiovascular events had a much higher mortality rate than those without cardiovascular events (45.2% vs. 8.7%,
p
<0.001). There was no difference between African Americans and Whites regarding mortality (43.9% vs 46.3%,
p
=1) and length of stay for survivors (11 days vs. 9.5 days,
p
=0.301). Multiple logistics regression analysis suggested that male, race, lower SaO2/FiO2, higher serum potassium, lower serum albumin, and number of cardiovascular co-morbidities were highly associated with the occurrence of cardiovascular events in COVID-19 patients. Lower serum albumin and neoplastic/immune compromised diseases were highly associated with cardiovascular events for African American COVID-19 patients. SaO2/FiO2 ratio and cardiovascular comorbidity count were significantly associated with cardiovascular events in white patients.
Conclusions
: Cardiovascular events were prevalent and associated with worse outcomes in hospitalized patients with COVID-19. Outcomes of cardiovascular events in African American and white COVID-19 patients were similar after propensity score matching analysis. There were common and unique risk factors for cardiovascular events in African American COVID-19 patients when compared with white patients.
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