In-hospital outcomes of COVID-19 infection in patients with underlying cardiovascular disease

ABSTRACT

Background

The effects of cardiovascular comorbidities on outcomes in COVID-19 hospitalized patients has not been well studied.

Methods

This is a hospital-based study evaluating the effects of CVD on the outcomes in patients admitted with COVID-19. Clinical outcomes were studied in patients with and without CVD.

Results

Eighty-seven patients had CVD, and 193 patients had no history of CVD. Ischemic heart disease was the most common CVD (63%). When compared with patients with no CVD, those with CVD had higher mortality (29% vs 9%, p < 0.001), discharge to a skilled nursing facility (SNF) (36% vs 15%, p < 0.001), and change of code status to ‘do not resuscitate’ (41% vs 14%, p < 0.001). The odds for mortality were high with ischemic heart disease (OR 3.6, 95% CI 1.8–7.3, p < 0.001), and systolic heart failure (OR 3.8,95% CI 1.2–12.3, p = 0.02). Patients in the CVD group were more likely to have incident atrial fibrillation (22% vs 3%, p < 0.001), type 2 Mi (17% vs 6%, p = 0.002), high BNP (57% vs 14%, p < 0.001), acute kidney injury (64% vs 29%, p < 0.001), and any type of circulatory shock (27% vs 12%, p = 0.001).

Conclusion

CVD is associated with increased mortality, myocardial injury, arrhythmias, and discharges to an SNF.

KEYWORDS:

• COVID-19
• cardiovascular disease
• myocardial injury

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Declarations

Ethics approval: IRB approval was obtained from Promedica Health system in Toledo, Oh, USA. The study protocol was carried out in accordance with the Declaration of Helsinki. Consent to participate was waived by the IRB Promedica Health system in Toledo, OH, USA due to retrospective design of the study.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Author contributions

K.Changal: Concept, design, data collection, data analysis, manuscript writing/editing. D. Paternite: Sean Mack BS, Spiro Verija MS BS, Rehana Bashir MDS: Data collection, manuscript editing and review. M. Patel, R. Soni, M. Ali, T. Mir: Review of data, manuscript editing, critical review. M. Sheikh, P.K. Ramanathan: Senior authors, concept, design, manuscript review and editing. All authors reviewed the manuscript.

Data and material availability

The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

Additional information

Funding

This paper was not funded.