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COVID-19: a risk factor for fatal outcomes in patients with comorbid cardiovascular disease
1Department of Anesthesiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Insights
Patients with cardiovascular disease (CVD) faced a significantly higher COVID-19 mortality risk. Acute respiratory distress syndrome was the main cause of death in these patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Cardiovascular disease (CVD) is a significant comorbidity globally.
- COVID-19 has been associated with increased mortality, particularly in vulnerable populations.
Purpose of the Study:
- To investigate the impact of comorbid cardiovascular disease on COVID-19 patient mortality.
- To identify clinical and laboratory differences between COVID-19 patients with and without CVD.
Main Methods:
- Retrospective study of 64 COVID-19 patients.
- Propensity score matching to create comparable groups with and without comorbid CVD.
- Comparison of clinical symptoms, laboratory markers, treatments, and 28-day mortality.
Main Results:
- COVID-19 patients with comorbid CVD had a 3.25 times higher 28-day mortality rate (40.63% vs 12.50%).
- Elevated levels of Interleukin-10, procalcitonin, troponin I, and lactic dehydrogenase were observed in patients with CVD.
- Higher incidence of acute respiratory distress syndrome (ARDS) and increased need for mechanical ventilation in the CVD group.
Conclusions:
- Comorbid CVD significantly increases mortality risk in COVID-19 patients.
- Acute respiratory distress syndrome is the primary cause of death in COVID-19 patients with CVD.
- Acute myocardial infarction is a secondary cause of death in this patient group.
Objectives:
To evaluate the fatal impact of COVID-19 on patients with comorbid cardiovascular disease (CVD).
Results:
Overall, the 28-day mortality of patients with comorbid CVD was 3.25 times of that of patients without comorbid CVD (40.63% vs 12.50%, P=0.011). Clinic symptoms on admission were similar for the two groups. However, patients with comorbid CVD had higher levels of Interleukin-10 (22.22% vs 0%, P=0.034), procalcitonin (22.6% vs 3.13%, P<0.001), high-sensitivity troponin I (20 pg/mL vs 16.05 pg/mL, P=0.019), and lactic dehydrogenase (437 U/L vs 310 U/L, P=0.015). In addition, patients with comorbid CVD experienced a high incidence of acute respiratory distress syndrome (59.38% vs 15.63%, P<0.001), and required more invasive mechanical ventilation (40.63% vs 12.50%, P=0.011). Methylprednisolone was found to improve the survival of patients without comorbid CVD (p = 0.05).
Conclusions:
Comorbid CVD resulted in a higher mortality rate for COVID-19 patients. Acute respiratory distress syndrome was the primary reason of death for COVID-19 patients with comorbid CVD, followed by acute myocardial infarction.
Methods:
This retrospective study used propensity score matching to divide 64 COVID-19 patients into two groups with and without comorbid CVD. Clinic symptoms, laboratory features, treatments, and 28-day mortality were compared between the two groups.
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