Research Paper|Volume 12, Issue 19|pp 18866—18877

COVID-19: a risk factor for fatal outcomes in patients with comorbid cardiovascular disease

Hui Xu¹, Ling Ai¹, Chun Qiu², Xi Tan¹, Bo Jiao¹, Ailin Luo¹, Shusheng Li³, Shangkun Liu¹, Li Yan³

¹Department of Anesthesiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
²Lazaridis School of Business and Economics, Wilfrid Laurier University, Waterloo N2L3C5, Canada
³Department of Emergency, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

* Equal contribution

Received: April 20, 2020Accepted: August 3, 2020Published: October 9, 2020

Copyright: © 2020 Xu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Objectives: To evaluate the fatal impact of COVID-19 on patients with comorbid cardiovascular disease (CVD).

Results: Overall, the 28-day mortality of patients with comorbid CVD was 3.25 times of that of patients without comorbid CVD (40.63% vs 12.50%, P=0.011). Clinic symptoms on admission were similar for the two groups. However, patients with comorbid CVD had higher levels of Interleukin-10 (22.22% vs 0%, P=0.034), procalcitonin (22.6% vs 3.13%, P<0.001), high-sensitivity troponin I (20 pg/mL vs 16.05 pg/mL, P=0.019), and lactic dehydrogenase (437 U/L vs 310 U/L, P=0.015). In addition, patients with comorbid CVD experienced a high incidence of acute respiratory distress syndrome (59.38% vs 15.63%, P<0.001), and required more invasive mechanical ventilation (40.63% vs 12.50%, P=0.011). Methylprednisolone was found to improve the survival of patients without comorbid CVD (p = 0.05).

Conclusions: Comorbid CVD resulted in a higher mortality rate for COVID-19 patients. Acute respiratory distress syndrome was the primary reason of death for COVID-19 patients with comorbid CVD, followed by acute myocardial infarction.

Methods: This retrospective study used propensity score matching to divide 64 COVID-19 patients into two groups with and without comorbid CVD. Clinic symptoms, laboratory features, treatments, and 28-day mortality were compared between the two groups.