Abstract

Background and objectiveSeveral cardiovascular risk factors have emerged as important determinants of severe illness and death among coronavirus disease 2019 (COVID-19) patients. However, the full impact of these cardiovascular risk factors is still under investigation. This study aimed to investigate the association between patients' level of cardiovascular risk and the severity of COVID-19.Materials and methodsThis observational study included all adult patients with COVID-19 hospitalized at Sheikh Khalifa Ibn Zaid International University Hospital from March 20 to May 10, 2020. The cardiovascular risk level was assessed by the doctor responsible for each patient based on the 2019 European Society of Cardiology (ESC), the European Atherosclerosis Society (EAS), and the European Association for the Study of Diabetes (EASD) guidelines. We examined the association between the patients' level of cardiovascular risk and their severity of COVID-19 disease by using a logistic regression model.ResultsAmong 133 patients with confirmed COVID-19, 46.6% had a low cardiovascular risk level, 19.5% had a moderate risk level, 15.8% had a high risk level, and 18.1% was found to have a very high risk level. Patients with different cardiovascular risk levels had significantly different rates of complications including secondary infection (p-value: <0.001), acute respiratory distress syndrome (ARDS) (p-value = 0.017), intensive care unit (ICU) admission (p-value: <0.001), and death (p-value: <0.001). A patient's very high cardiovascular risk level versus low, moderate, or high cardiovascular risk level was independently associated with ICU admission [OR = 6.42, 95% CI: (1.45-28.30)].ConclusionBased on our findings, an increased level of cardiovascular risk among patients was strongly associated with the severity of COVID-19. This study also highlights the need for assessing cardiovascular risk factors in all patients with COVID-19.

Highlights

  • The novel coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China in December 2019, and since it has spread rapidly around the world

  • The cardiovascular risk level was assessed by the doctor responsible for each patient based on the 2019 European Society of Cardiology (ESC), the European Atherosclerosis Society (EAS), and the European Association for the Study of Diabetes (EASD) guidelines

  • A patient's very high cardiovascular risk level versus low, moderate, or high cardiovascular risk level was independently associated with intensive care unit (ICU) admission [odds ratios (ORs) = 6.42, 95% confidence intervals (CIs): (1.45-28.30)]

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Summary

Introduction

The novel coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China in December 2019, and since it has spread rapidly around the world. Previous studies on the condition have observed that elderly patients and those with comorbidities such as diabetes, hypertension, and cardiovascular diseases are more likely to develop severe forms of COVID-19, with more complications and/or more susceptibility to death from the disease [3,4]. The impact of these cardiovascular risk factors such as age, hypertension, diabetes, and cardiovascular diseases on the clinical outcomes and the prognosis of COVID-19 disease is still poorly understood. This study investigated the association between the level of the patients' cardiovascular risk and the severity of COVID-19. Several cardiovascular risk factors have emerged as important determinants of severe illness and death among coronavirus disease 2019 (COVID-19) patients. This study aimed to investigate the association between patients' level of cardiovascular risk and the severity of COVID-19

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