Abstract 16713: Major Adverse Cardiovascular Events are Linked to Risk of Mortality in Covid-19 Patients

Abstract

Introduction: As a predominantly respiratory viral illness, it comes as no surprise that severe respiratory failure has portended greater risk of mortality in COVID-19 patients. We aimed to investigate whether the occurrence of a major adverse cardiovascular event (MACE) was an indicator of higher risk of eventual death in COVID-19 infected and hospitalized patients. Methods: A retrospective review was performed on 225 hospitalized patients that tested positive for COVID-19 between March and May 2020 at a major quaternary care hospital in a metropolitan area of the southwestern United States. Baseline characteristics and clinical outcomes of their disease course were identified. Survival analyses were performed on this patient pool, which was divided into two cohorts: (i) patients that experienced a MACE [a composite of myocardial infarction (MI), stroke, pulmonary embolism (PE), deep venous thrombosis (DVT), or shock requiring vasopressor support] and (ii) patients that did not experience a MACE. Pearson’s chi square test was used to examine the difference in mortality between those who had a MACE and those who did not have a MACE. Results: Of the 222 hospitalized patients for whom final discharge disposition was available, 59 had a MACE, and 163 did not. Specifically, 19 (8.59%) patients experienced a type 1 or type 2 MI, 3 (1.36%) experienced stroke, 7 (3.20%) experienced PE/DVT, and 37 (16.67%) experienced shock. A significant difference in mortality was observed between those who had a MACE and those who did not have a MACE [p-value <0.0001, OR = 11.23; 95% CI = 4.29 31.33]. In the “No MACE” cohort, 61.52% were alive after t = 43 days; 30.33% of the “Yes MACE” were alive after t = 43 days. More than 50% of the COVID-19 patients that had a MACE died by day 23 of hospitalization. Conclusions: Based on our data, hospitalized COVID-19 patients who experience a MACE are over 11 times more likely to die than those who did not experience a MACE. As such, it is important for clinicians to remain vigilant in assessing for the occurrence of these events, and to promptly respond to them with an evidence-based approach.