RT Journal Article
SR Electronic
T1 Mortality and high risk of major adverse events in patients with COVID-19 and history of cardiovascular disease
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e001526
DO 10.1136/openhrt-2020-001526
VO 8
IS 1
A1 Elena Tessitore
A1 David Carballo
A1 Antoine Poncet
A1 Nils Perrin
A1 Cedric Follonier
A1 Benjamin Assouline
A1 Sebastian Carballo
A1 François Girardin
A1 Francois Mach
YR 2021
UL http://openheart.bmj.com/content/8/1/e001526.abstract
AB Objective History of cardiovascular diseases (CVDs) may influence the prognosis of patients hospitalised for COVID-19. We investigated whether patients with previous CVD have increased risk of death and major adverse cardiovascular event (MACE) when hospitalised for COVID-19.Methods We included 839 patients with COVID-19 hospitalised at the University Hospitals of Geneva. Demographic characteristics, medical history, laboratory values, ECG at admission and medications at admission were collected based on electronic medical records. The primary outcome was a composite of in-hospital mortality or MACE.Results Median age was 67 years, 453 (54%) were males and 277 (33%) had history of CVD. In total, 152 (18%) died and 687 (82%) were discharged, including 72 (9%) who survived a MACE. Patients with previous CVD were more at risk of composite outcomes 141/277 (51%) compared with those without CVD 83/562 (15%) (OR=6.0 (95% CI 4.3 to 8.4), p<0.001). Multivariate analyses showed that history of CVD remained an independent risk factor of in-hospital death or MACE (OR=2.4; (95% CI 1.6 to 3.5)), as did age (OR for a 10-year increase=2.2 (95% CI 1.9 to 2.6)), male gender (OR=1.6 (95% CI 1.1 to 2.3)), chronic obstructive pulmonary disease (OR=2.1 (95% CI 1.0 to 4.2)) and lung infiltration associated with COVID-19 at CT scan (OR=1.9 (95% CI 1.2 to 3.0)). History of CVD (OR=2.9 (95% CI 1.7 to 5)), age (OR=2.5 (95% CI 2.0 to 3.2)), male gender (OR=1.6 (95% CI 0.98 to 2.6)) and elevated C reactive protein (CRP) levels on admission (OR for a 10 mg/L increase=1.1 (95% CI 1.1 to 1.2)) were independent risk factors for mortality.Conclusion History of CVD is associated with higher in-hospital mortality and MACE in hospitalised patients with COVID-19. Other factors associated with higher in-hospital mortality are older age, male sex and elevated CRP on admission.All the raw data presented in this article are available on reasonable request to elena.tessitore@hcuge.ch, as well as the protocol of the study. No supplemental unpublished data will be given. Data are reusable on specific request. ET is the grantor of these data.