Cardiometabolic Disorders and the Risk of Critical COVID-19 as Compared to Influenza Pneumonia.

Antoine Fayol,Caroline Hauw,Bernard Cholley,David Lebeaux,Tristan Mirault,Nihar Masurkar,Marine Livrozet,Geoffroy Volle,Michel Azizi,Olivier Sanchez,Benjamin Planquette,Gilles Châtellier,Sébastien Czernichow,Héléna Pereira,Jean‐Luc Diehl ,Jean-Baptiste Carvès ,C Carette ,Sophie-Rym Hamada,Jean‐Benoît Arlet ,Anne‐Sophie Jannot ,Jean‐Sébastien Hulot

doi:10.3390/jcm10194618

Abstract

We aimed to compare the influence of cardiometabolic disorders on the incidence of severe COVID-19 vs. non-COVID pneumonia. We included all consecutive patients admitted with SARS-CoV-2-positive pneumonia between 12 March 2020 and 1 April 2020 and compared them to patients with influenza pneumonia hospitalized between December 2017 and December 2019 at the same tertiary hospital in Paris. Patients with COVID-19 were significantly younger and more frequently male. In the analysis adjusted for age and sex, patients with COVID-19 were more likely to be obese (adjOR: 2.25; 95% CI 1.24–4.09; p = 0.0076) and receive diuretics (adjOR: 2.13; 95% CI 1.12–4.03; p = 0.021) but were less likely to be smokers (adjOR: 0.40; 95% CI 0.24–0.64; p = 0.0002), have COPD (adjOR: 0.25; 95% CI 0.11–0.56; p = 0.0008), or have a previous or active cancer diagnosis (adjOR: 0.54, 95% CI 0.32–0.91; p = 0.020). The rate of ICU admission was significantly higher in patients with COVID-19 (32.4% vs. 5.2% p < 0.0001). Obesity was significantly associated with the risk of direct ICU admission in patients with COVID-19 but not in patients with influenza pneumonia. Likewise, pre-existing hypertension was significantly associated with mortality in patients with COVID-19 but not in patients with influenza pneumonia. Cardiometabolic disorders differentially influenced the risk of presenting with severe COVID-19 or influenza pneumonia.

Highlights

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative agent of COVID-19, an infection that primarily targets the lungs [1]
Non-intensive care unit (ICU) patients. (B) Non-ICU patients. This single-center analysis was performed on 253 initial COVID-19 patients admitted from 12 March 2020 to 1 April 2020, providing a picture of the first COVID-19 cases with severe and critical pneumonia as the SARS-CoV-2 epidemic expanded in France before the initiation of a lockdown on 16 March 2020
Our results demonstrate a characteristic link between COVID-19 and hypertension that may have practical implications

Summary

Introduction

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative agent of COVID-19, an infection that primarily targets the lungs [1]. Cardiac, vascular, and metabolic disorders including hypertension, coronary heart disease, diabetes, and obesity are highly prevalent among patients with severe COVID-19 [2,3,4,5,6], and mortality rates tend to be higher in those with cardiometabolic comorbidities [7,8]. Severe COVID-19 is more prevalent in patients aged greater than 50 years [2,3,8,9], a population that largely overlaps with those most at risk for or already having a history of hypertension, diabetes, or other cardiometabolic diseases [10]. Age and cardiometabolic diseases are independently associated with the occurrence of non-COVID pneumonia [11]. Patients with known cardiovascular diseases are at higher risk of severe outcomes when suffering from lower respiratory tract infections, especially those related to influenza [13]

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