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Cardiovascular comorbidities as predictors for severe COVID-19 infection or death

Matthew Phelps1, Daniel Mølager Christensen1, Thomas Gerds2

  • 1The Danish Heart Foundation, Copenhagen, Denmark.

European Heart Journal. Quality of Care & Clinical Outcomes
|October 27, 2020
PubMed

Insights

Pre-existing cardiovascular diseases (CVDs) do not significantly increase severe COVID-19 or mortality risk in older adults. This finding allows for more personalized guidance for cardiovascular patients regarding coronavirus disease 2019 (COVID-19) risk.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Conflicting evidence exists regarding the impact of pre-existing cardiovascular diseases (CVDs) on adverse coronavirus disease 2019 (COVID-19) outcomes.
  • It remains unclear if CVDs are independent predictors of severe COVID-19.

Purpose of the Study:

  • To investigate if pre-existing CVDs predict the 30-day risk of severe COVID-19 and all-cause mortality in hospital-screened COVID-19 patients aged 40 and older.
  • To illustrate the importance of CVD comorbidities by evaluating predicted risks of death and severe infection across different ages and sexes.

Main Methods:

  • Nationwide Danish cohort study of hospital-screened COVID-19 patients (aged ≥40).
  • Cox regression model used to estimate 30-day risks, adjusting for age, sex, CVDs, COPD-asthma, diabetes, and chronic kidney disease.
  • Analysis included 4090 patients, with 22.1% having ≥1 CVD, 23.7% experiencing severe infection, and 12.6% mortality within 30 days.

Main Results:

  • For men aged 75, single CVD comorbidities did not significantly increase the risk of severe infection or death compared to men without comorbidities.
  • Women with heart failure or atrial fibrillation showed modest increases in the risk of severe infection compared to women without comorbidities.
  • Overall, pre-existing CVDs showed only modest effects on increased risks of poor COVID-19 outcomes.

Conclusions:

  • The modest impact of CVDs on COVID-19 outcomes suggests that cardiovascular patients may not universally face high risk.
  • Public health authorities and clinicians can provide more tailored guidance to cardiovascular patients based on these findings.
  • This research refines risk stratification for COVID-19 in individuals with pre-existing cardiovascular conditions.
Abstract

Keywords:
COVID-19Cardiovascular comorbiditiesMorbidityMortalityPre-existing conditionsSevere outcomes

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