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The effect of vascular risk factor burden on the severity of COVID-19 illness, a retrospective cohort study
Houwei Du1,2, Xiaobin Pan3, Nan Liu4,5
1Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China. duhouwei@outlook.com.
Insights
Patients with more vascular risk factors face a higher risk of severe COVID-19 illness. This highlights the need for targeted prevention and early treatment strategies for individuals with multiple risk factors.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Patients with cardiovascular comorbidities face elevated risks from COVID-19.
- The impact of vascular risk factor burden on severe COVID-19 outcomes requires further investigation.
Purpose of the Study:
- To examine the association between the number of vascular risk factors and the severity of COVID-19 illness.
- To determine if a higher burden of vascular risk factors correlates with increased risk of severe COVID-19.
Main Methods:
- Retrospective study of 164 COVID-19 patients.
- Comparison of clinical, laboratory, and chest CT findings between severe and non-severe COVID-19 cases.
- Cox regression analysis to evaluate the association between vascular risk factor count and severe disease development.
Main Results:
- A higher number of vascular risk factors was significantly associated with an increased risk of severe COVID-19 (log-rank P < 0.001).
- Even after adjusting for age, sex, and comorbidities, the burden of vascular risk factors remained a significant predictor of severe COVID-19.
- 17.7% of patients experienced severe COVID-19, with risk escalating with each additional vascular risk factor.
Conclusions:
- Increasing vascular risk factor burden directly correlates with a heightened risk of severe COVID-19.
- Individuals with multiple vascular risk factors may benefit from specific preventive measures like self-isolation and prompt medical attention.
Background:
Patients with cardiovascular comorbidities are at high risk of poor outcome from COVID-19. However, how the burden (number) of vascular risk factors influences the risk of severe COVID-19 disease remains unresolved. Our aim was to investigate the association of severe COVID-19 illness with vascular risk factor burden.
Methods:
We included 164 (61.8 ± 13.6 years) patients with COVID-19 in this retrospective study. We compared the difference in clinical characteristics, laboratory findings and chest computed tomography (CT) findings between patients with severe and non-severe COVID-19 illness. We evaluated the association between the number of vascular risk factors and the development of severe COVID-19 disease, using a Cox regression model.
Results:
Sixteen (9.8%) patients had no vascular risk factors; 38 (23.2%) had 1; 58 (35.4%) had 2; 34 (20.7%) had 3; and 18 (10.9%) had ≥4 risk factors. Twenty-nine patients (17.7%) experienced severe COVID-19 disease with a median (14 [7-27] days) duration between onset to developing severe COVID-19 disease, an event rate of 4.47 per 1000-patient days (95%CI 3.10-6.43). Kaplan-Meier curves showed a gradual increase in the risk of severe COVID-19 illness (log-rank P < 0.001) stratified by the number of vascular risk factors. After adjustment for age, sex, and comorbidities as potential confounders, vascular risk factor burden remained associated with an increasing risk of severe COVID-19 illness.
Conclusions:
Patients with increasing vascular risk factor burden have an increasing risk of severe COVID-19 disease, and this population might benefit from specific COVID-19 prevention (e.g., self-isolation) and early hospital treatment measures.
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