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Cardiovascular therapy use, modification, and in-hospital death in patients with COVID-19: A cohort study

Cédric Follonier1,2, Elena Tessitore1, Sandra Handgraaf1

  • 1Division of Cardiology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland.

Plos One
|November 23, 2022
PubMed

Insights

Continuing pre-hospital cardiovascular therapies is recommended for COVID-19 patients. Modifications during hospitalization, like starting renin-angiotensin agents, improved survival, while others like discontinuing beta-blockers increased death risk.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Coronavirus disease 2019 (COVID-19) poses significant risks to hospitalized patients.
  • Cardiovascular therapies are commonly used in patients with pre-existing conditions.
  • Understanding the impact of these therapies on COVID-19 outcomes is crucial.

Purpose of the Study:

  • To investigate the association between exposure to and modifications in exposure to eight common cardiovascular therapies.
  • To assess the risk of in-hospital death among unvaccinated adult patients with COVID-19.

Main Methods:

  • Observational study of 838 unvaccinated adult patients hospitalized with COVID-19.
  • Logistic regression models were used to analyze the association between cardiovascular therapies and in-hospital death.
  • Adjustments were made for potential confounding factors.

Main Results:

  • No pre-hospital cardiovascular therapy was associated with increased in-hospital death risk.
  • During hospitalization, diuretic use increased death risk, while renin-angiotensin system agents and lipid-lowering agents reduced it.
  • Discontinuation of renin-angiotensin system agents, beta-blockers, lipid-modifying agents, or anticoagulants increased death risk.
  • Initiation of renin-angiotensin system agents improved survival, whereas initiation of diuretics or antiarrhythmics increased death risk.

Conclusions:

  • Pre-hospital cardiovascular medication use in COVID-19 patients is not associated with increased in-hospital mortality.
  • Existing cardiovascular therapies should be continued as prescribed for hospitalized COVID-19 patients.
  • Specific modifications during hospitalization, such as initiating renin-angiotensin system agents, can improve outcomes.
Abstract

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