Outcomes and Risk Factors for Cardiovascular Events in Hospitalized COVID-19 Patients

Abstract

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.

Electrocardiographic Features and Outcome: Correlations in 124 Hospitalized Patients With COVID-19 and Cardiovascular Events

“…The Center of Excellence for Research in Infectious Diseases (CERID) recently analyzed 702 adult COVID-19 patients hospitalized between March 2020 and June 2020 in a United States metropolitan area and identified 124 patients who suffered cardiovascular (CV) events. 18 Patients with cardiovascular events had a much higher mortality rate at 45.2% than those without cardiovascular events at 8.7%. 18 The null hypothesis for this project was there is no significant difference between ECGs at admission, CV events and discharge (death or out of hospital).…”

“…18 Patients with cardiovascular events had a much higher mortality rate at 45.2% than those without cardiovascular events at 8.7%. 18 The null hypothesis for this project was there is no significant difference between ECGs at admission, CV events and discharge (death or out of hospital). The purpose of this study was to investigate the ECG features in COVID-19 patients who suffered CV events at three distinct phases of hospitalization: upon admission, during the acute CV event, and on approaching discharge or death.…”

Premorbid aspirin use is not associated with lower mortality in older inpatients with SARS-CoV-2 pneumonia

“…[14] However, age and pneumonia severity have been shown to be strongly associated with CV risk in COVID-19. [15][16][17] A large retrospective study comparing short-term outcomes in COVID-19 veterans with or without preexisting aspirin prescription [18] highlighted a decrease in overall mortality of over 50% in individuals prescribed aspirin. Despite the advanced age of the population, these interesting data mostly concerned low-risk ambulatory patients with relatively low 30-day mortality (5%).…”

Understanding ST-Elevation Myocardial Infarction in COVID-19: The Marriage of Bench Work and Big Data

“…The reasons for this are two-fold: 1) difficulty in correct diagnosis due to the overlap of symptoms with COVID and myocardial infarction, especially dyspnea and chest pain, and 2) the immediate need for reorganization and triage of every hospitalized patient in order to treat patients with COVID and to mitigate the spread of COVID 19. [8] …”