Do underlying cardiovascular diseases have any impact on hospitalised patients with COVID-19?

Heart. 2020 Aug;106(15):1148-1153. doi: 10.1136/heartjnl-2020-316909. Epub 2020 May 25.

Abstract

Objectives: An outbreak of the highly contagious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has sickened thousands of people in China. The purpose of this study was to explore the early clinical characteristics of COVID-19 patients with cardiovascular disease (CVD).

Methods: This is a retrospective analysis of patients with COVID-19 from a single centre. All patients underwent real-time reverse transcription PCR for SARS-CoV-2 on admission. Demographic and clinical factors and laboratory data were reviewed and collected to evaluate for significant associations.

Results: The study included 541 patients with COVID-19. A total of 144 (26.6%) patients had a history of CVD. The mortality of patients with CVD reached 22.2%, which was higher than that of the overall population of this study (9.8%). Patients with CVD were also more likely to develop liver function abnormality, elevated blood creatinine and lactic dehydrogenase (p<0.05). Symptoms of sputum production were more common in patients with CVD (p=0.026). Lymphocytes, haemoglobin and albumin below the normal range were pervasive in the CVD group (p<0.05). The proportion of critically ill patients in the CVD group (27.8%) was significantly higher than that in the non-CVD group (8.8%). Multivariable logistic regression analysis revealed that CVD (OR: 2.735 (95% CI 1.495 to 5.003), p=0.001) was associated with critical COVID-19 condition, while patients with coronary heart disease were less likely to reach recovery standards (OR: 0.331 (95% CI 0.125 to 0.880), p=0.027).

Conclusions: Considering the high prevalence of CVD, a thorough CVD assessment at diagnosis and early intervention are recommended in COVID-19 patients with CVD. Patients with CVD are more vulnerable to deterioration.

Keywords: cardiac rehabilitation; cardiac risk factors and prevention; electronic medical records; hypertension.

MeSH terms

  • Age Factors
  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Betacoronavirus*
  • COVID-19
  • Cardiovascular Diseases / epidemiology*
  • China / epidemiology
  • Clinical Deterioration
  • Coronavirus Infections / epidemiology*
  • Creatinine / blood
  • Critical Illness
  • Female
  • Hemoglobins / analysis
  • Hospitalization*
  • Humans
  • L-Lactate Dehydrogenase / blood
  • Lymphopenia / epidemiology
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / epidemiology*
  • Recovery of Function
  • Retrospective Studies
  • SARS-CoV-2
  • Serum Albumin
  • Severity of Illness Index*

Substances

  • Hemoglobins
  • Serum Albumin
  • Creatinine
  • L-Lactate Dehydrogenase
  • Aspartate Aminotransferases
  • Alanine Transaminase