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

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@article{4e06a290f07c402482648a68f52ae17e,
title = "Cardiovascular comorbidities as predictors for severe COVID-19 infection or death",
abstract = "BACKGROUND: Pre-existing cardiovascular diseases (CVDs) have been proposed to identify patients at higher risk of adverse COVID-19 outcomes, but existing evidence is conflicting. Thus, it is unclear whether pre-existing CVDs are independently important predictors for severe COVID-19.METHODS AND RESULTS: In a nationwide Danish cohort of hospital-screened COVID-19 patients aged > =40, we investigated if pre-existing CVDs predict the 30-day risk of (1) composite outcome of severe COVID-19 and (2) all-cause mortality. We estimated 30-day risks using a Cox regression model including age, sex, each CVD comorbidity, COPD-asthma, diabetes, and chronic kidney disease. To illustrate CVD comorbidities' importance, we evaluated the predicted risks of death and severe infection, for each sex, along ages 40 - 85. 4,090 COVID-19 hospital-screened patients were observed as of August 26, 2020; 22.1{\%} had ≥ 1 CVD, 23.7{\%} had severe infection within 30 days and 12.6{\%} died. Predicted risks of both outcomes at age 75 among men with single CVD comorbidities did not differ in clinically meaningful amounts compared to men with no comorbidities risks for the composite outcome of severe infection; women with heart failure (28.2{\%}; 95{\%} CI 21.1{\%}-37.0{\%}) or atrial fibrillation (30.0{\%}; 95{\%} CI: 24.2{\%}-36.9{\%}) showed modest increases compared to women with no comorbidities (24.0{\%}; 95{\%} CI: 21.4{\%}-26.9{\%}).CONCLUSIONS: The results showing only modest effects of CVDs on increased risks of poor COVID-19 outcomes are important in allowing public health authorities and clinicians to provide more tailored guidance to cardiovascular patients, who have heretofore been grouped together as high-risk due to their disease status.",
author = "Matthew Phelps and Christensen, {Daniel M{\o}lager} and Thomas Gerds and Emil Fosb{\o}l and Christian Torp-Pedersen and Morten Schou and Lars K{\o}ber and Kristian Kragholm and Charlotte Andersson and Tor Biering-S{\o}rensen and Christensen, {Helle Collatz} and Andersen, {Mikkel Porsborg} and Gunnar Gislason",
note = "{\circledC} The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.",
year = "2020",
month = "10",
day = "27",
doi = "10.1093/ehjqcco/qcaa081",
language = "English",
journal = "European heart journal. Quality of care & clinical outcomes",
issn = "2058-5225",
publisher = "Oxford University Press",

}

RIS

TY - JOUR

T1 - Cardiovascular comorbidities as predictors for severe COVID-19 infection or death

AU - Phelps, Matthew

AU - Christensen, Daniel Mølager

AU - Gerds, Thomas

AU - Fosbøl, Emil

AU - Torp-Pedersen, Christian

AU - Schou, Morten

AU - Køber, Lars

AU - Kragholm, Kristian

AU - Andersson, Charlotte

AU - Biering-Sørensen, Tor

AU - Christensen, Helle Collatz

AU - Andersen, Mikkel Porsborg

AU - Gislason, Gunnar

N1 - © The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.

PY - 2020/10/27

Y1 - 2020/10/27

N2 - BACKGROUND: Pre-existing cardiovascular diseases (CVDs) have been proposed to identify patients at higher risk of adverse COVID-19 outcomes, but existing evidence is conflicting. Thus, it is unclear whether pre-existing CVDs are independently important predictors for severe COVID-19.METHODS AND RESULTS: In a nationwide Danish cohort of hospital-screened COVID-19 patients aged > =40, we investigated if pre-existing CVDs predict the 30-day risk of (1) composite outcome of severe COVID-19 and (2) all-cause mortality. We estimated 30-day risks using a Cox regression model including age, sex, each CVD comorbidity, COPD-asthma, diabetes, and chronic kidney disease. To illustrate CVD comorbidities' importance, we evaluated the predicted risks of death and severe infection, for each sex, along ages 40 - 85. 4,090 COVID-19 hospital-screened patients were observed as of August 26, 2020; 22.1% had ≥ 1 CVD, 23.7% had severe infection within 30 days and 12.6% died. Predicted risks of both outcomes at age 75 among men with single CVD comorbidities did not differ in clinically meaningful amounts compared to men with no comorbidities risks for the composite outcome of severe infection; women with heart failure (28.2%; 95% CI 21.1%-37.0%) or atrial fibrillation (30.0%; 95% CI: 24.2%-36.9%) showed modest increases compared to women with no comorbidities (24.0%; 95% CI: 21.4%-26.9%).CONCLUSIONS: The results showing only modest effects of CVDs on increased risks of poor COVID-19 outcomes are important in allowing public health authorities and clinicians to provide more tailored guidance to cardiovascular patients, who have heretofore been grouped together as high-risk due to their disease status.

AB - BACKGROUND: Pre-existing cardiovascular diseases (CVDs) have been proposed to identify patients at higher risk of adverse COVID-19 outcomes, but existing evidence is conflicting. Thus, it is unclear whether pre-existing CVDs are independently important predictors for severe COVID-19.METHODS AND RESULTS: In a nationwide Danish cohort of hospital-screened COVID-19 patients aged > =40, we investigated if pre-existing CVDs predict the 30-day risk of (1) composite outcome of severe COVID-19 and (2) all-cause mortality. We estimated 30-day risks using a Cox regression model including age, sex, each CVD comorbidity, COPD-asthma, diabetes, and chronic kidney disease. To illustrate CVD comorbidities' importance, we evaluated the predicted risks of death and severe infection, for each sex, along ages 40 - 85. 4,090 COVID-19 hospital-screened patients were observed as of August 26, 2020; 22.1% had ≥ 1 CVD, 23.7% had severe infection within 30 days and 12.6% died. Predicted risks of both outcomes at age 75 among men with single CVD comorbidities did not differ in clinically meaningful amounts compared to men with no comorbidities risks for the composite outcome of severe infection; women with heart failure (28.2%; 95% CI 21.1%-37.0%) or atrial fibrillation (30.0%; 95% CI: 24.2%-36.9%) showed modest increases compared to women with no comorbidities (24.0%; 95% CI: 21.4%-26.9%).CONCLUSIONS: The results showing only modest effects of CVDs on increased risks of poor COVID-19 outcomes are important in allowing public health authorities and clinicians to provide more tailored guidance to cardiovascular patients, who have heretofore been grouped together as high-risk due to their disease status.

U2 - 10.1093/ehjqcco/qcaa081

DO - 10.1093/ehjqcco/qcaa081

M3 - Journal article

JO - European heart journal. Quality of care & clinical outcomes

JF - European heart journal. Quality of care & clinical outcomes

SN - 2058-5225

ER -

ID: 61116592