Infectious Disease

CVD risk factors confer elevated risk for mortality in severe COVID-19

October 16, 2022

2 min read

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Disclosures:
Hayek reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

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CVD risk factors were associated with mortality in patients hospitalized for COVID-19, but preexisting CVD was not, researchers reported in Circulation: Cardiovascular Quality and Outcomes.

Further, myocardial injury, with or without CVD, was linked to increased odds of death or CV events in this population, according to the researchers.

COVID variant

CVD risk factors were associated with mortality in patients hospitalized for COVID-19, but preexisting CVD was not.
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“The study findings highlight that death and cardiovascular complications of COVID-19 are related to the severity of the acute illness and the hyperinflammatory process rather than preexisting heart disease,” Salim S. Hayek, MD, medical director of the University of Michigan Frankel Cardiovascular Center, told Healio.

For the multicenter cohort study, Hayek and colleagues evaluated 5,133 adult patients who went to the ICU for COVID-19 from March to June 2020 to observe whether preexisting CVD was related to in-hospital mortality and CV events.

Researchers classified CVD as preexisting CAD, congestive HF or atrial fibrillation/flutter.

Death occurring in the hospital within 28 days of admission was the primary outcome, and secondary outcomes were CV events — such as cardiac arrest, new-onset arrhythmias, new-onset HF, myocarditis, pericarditis or stroke — within 14 days.

According to the researchers, 22.9% of patients had preexisting CVD. The mean age was 61 years, and 62.9% were men. Among the total cohort, 34.6% of patients died and 17.9% had a CV event.

When adjusted for multiple variables and comorbidities, the OR for death was 1.15 (95% CI, 0.98-1.34) in patients with preexisting CVD.

“The association was heavily attenuated when accounting for comorbidities, suggesting that cardiovascular risk factors rather than CVD … are the main contributors to in-hospital outcomes in patients with severe COVID-19,” the researchers wrote. “Indeed, age, BMI, smoking, hypertension and diabetes were the most important contributors to mortality.”

There was no independent relationship between preexisting CVD and CV events in this population.

Additionally, regardless of whether patients had CVD at admission, myocardial injury was associated with higher likelihood of death (adjusted OR = 1.93; 95% CI, 1.61-2.31) and CV events (aOR = 1.82; 95% CI, 1.47-2.24) in the study population, according to the researchers.

“These findings help clinicians counsel their patients on their risk of severe COVID-19 infection related to heart disease,” Hayek told Healio. “[They also] apply to the broad group of patients with heart disease. Patients who have more severe forms of heart disease who represent a much smaller proportion of these patients should be studied separately to more accurately determine their risk.”

For more information:

Salim S. Hayek, MD, can be reached at shayek@med.umich.edu.

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