Cardiovascular disease potentially contributes to the progression and poor prognosis of COVID-19

Abstract

Background and aim: A novel coronavirus severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) caused pneumonia, Coronavirus Disease 2019 (COVID-19), broke out in Wuhan, China in December 2019, and spread all over the world. Patients with COVID-19 showed huge differences in the hospital stay, progression, and prognosis. As reported, the comorbidities may play an important role in COVID-19. Here, we aim to address the role of cardiovascular disease (CVD) in the progression and prognosis of COVID-19.

Methods and results: Eighty-three confirmed COVID-19 patients were divided into CVD (n = 42) and non-CVD (n = 41) group according to their medical history. Medical records including demographic data, medical history, clinical characteristics, laboratory examinations, chest computed tomography (CT), and treatment measures were collected, analyzed, and compared between the two groups. COVID-19 patients with CVD showed (1) more severe pathological changes in the lungs, (2) elevated injury-related enzymes including α-hydroxybutyrate dehydrogenase (HDBH), lactic dehydrogenase (LDH), γ-glutamyltransferase (GGT), creatine kinase (CK), and alanine aminotransferase (ALT), (3) significantly increased uncontrolled inflammation related markers, such as c-reactive protein (CRP), interleukin (IL)-6, serum ferritin, erythrocyte sedimentation rate (ESR), and serum amyloid A (SAA), (4) serious hypercoagulable status reflected by increased D-dimer and serum fibrinogen (FIB), and (5) higher mortality, compared to COVID-19 patients without CVD.

Conclusions: Our data indicated that CVD is a strong risk factor for rapid progression and bad prognosis of COVID-19. More intensive medical care should be applied to patients with CVD to prevent rapid deterioration of the disease.

Keywords: COVID-19; Cardiovascular disease; Prognosis.

Figure 1

CT results of the patients with CVD and patients without CVD. A. The representative CT images of the patients with CVD and patients without CVD. B. The CT score of the patients with CVD and patients without CVD. P < 0.05 was considered statistically significant.

Figure 2

Biochemical examination results of the patients with CVD and patients without CVD.P < 0.05 was considered statistically significant.

Figure 3

Other laboratory tests of the patients with CVD and patients without CVD. A. Blood test results of the patients with CVD and patients without CVD. B. Inflammation-related laboratory results of the patients with CVD and patients without CVD. C. Coagulation-related laboratory results of the patients with CVD and patient without CVD. P < 0.05 was considered statistically significant.