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

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

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  • Matthew Phelps
  • Daniel Mølager Christensen
  • Thomas Gerds
  • Emil Fosbøl
  • Christian Torp-Pedersen
  • Morten Schou
  • Lars Køber
  • Kristian Kragholm
  • Charlotte Andersson
  • Tor Biering-Sørensen
  • Helle Collatz Christensen
  • Mikkel Porsborg Andersen
  • Gunnar Gislason
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AIMS : Pre-existing cardiovascular diseases (CVDs) have been proposed to identify patients at higher risk of adverse coronavirus disease 2019 (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 (i) composite outcome of severe COVID-19 and (ii) all-cause mortality. We estimated 30-day risks using a Cox regression model including age, sex, each CVD comorbidity, chronic obstructive pulmonary disease-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. In total, 4090 COVID-19 hospital-screened patients were observed as of 26 August 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 with 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 with 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.

OriginalsprogEngelsk
TidsskriftEuropean heart journal. Quality of care & clinical outcomes
Vol/bind7
Udgave nummer2
Sider (fra-til)172-180
Antal sider9
ISSN2058-5225
DOI
StatusUdgivet - 1 apr. 2021

ID: 61116592