BackgroundSeasonal variation in the hospital admission due to cardiovascular disease (CVDs) has been widely reported. However, very limited data on Bangladesh is available regarding this matter. The aim of the current study was to investigate the effect of seasonal variation on hospital admission due to CVDs in a leading hospital of Bangladesh.MethodsOver a period of two years (from May 2010 to April 2012), the number of patients hospitalized due to various CVDs and number of death among these hospitalized patients were recorded on a day-to-day basis. The data were recorded according to the chief reason of hospital admission such as myocardial infarction or MI (acute, old and non-ST elevation), unstable angina (UA), exaggeration of stable angina, acute left ventricular failure (LVF), cardiomyopathy (ischemic and dilated) or heart failure, syncope and arrhythmia. The data were cumulated and analyzed on month-wise and season-wise manner.ResultsA total of 8371 patients were admitted over the study period (5909 male and 2462 female; M/F ratio - 2.4:1). The highest number of patients were admitted during winter (n = 2839, 33.9%) and lowest during summer (n = 1648, 19.7%). The hospital admission was also significantly higher in winter compared to other seasons (p-value versus summer, autumn and spring was 0.018, 0.020 and 0.023 respectively). Acute MI (n = 2374), Acute LVF (n = 1582) and UA (n = 1277) were the top three reasons for hospitalization. Number of death also significantly higher in winter compared to other seasons (p-value versus summer, winter and spring was 0.044, 0.050 and 0.014 respectively).ConclusionA seasonal variation in the hospital admission due to CVDs with a peak in winter was clearly demonstrated in the study. These data could be useful to improve causative prevention measures, therapeutic management, and educational strategies.

Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Beximco Pharmaceutical Limited, Bangladesh OnBehalf Cardiology Study Group (Bangladesh) Background The fact that SAARS-Cov2 virus enters cells through ACE2 receptors and the Renin-Angiotensin-Aldosterone System Inhibitors (RAASi) upregulate the ACE2 receptors, there was speculation that use of RAASi may lead increased cellular entry of the virus.  There was a pause for a brief period of the use of RAASi in COVID 19 patients. But clinically the speculation has been found to be incorrect. Different professional societies come up with the assertion to continue to use RAASi. As the hesitancy among the clinicians appears to continue and there is no first hand data regarding the safety of the use of RAASi in Bangladeshi population, the study was undertaken to evaluate the safety of RAASi in COVID 19 patients. Aims & Methods This study was a prospective, observational multi-center study to evaluate the outcome of COVID-19 patients receiving RAAS inhibitors. Adult Hypertensive patients (age ≥18 years) with diagnosed COVID-19 confirmed by RT-PCR test who have a history of taking either ACE inhibitor/ARB or any other anti-hypertensive medication. Evaluation of outcome was assessed by rate of hospitalization, requirement of oxygen therapy, requirement of high flow nasal cannula, admission to ICU and mortality between two groups. All statistical analyses were performed using SPSS for Windows, version 20.0 (SPSS Inc., Chicago, IL, USA). Results We collected data from 147 Covid-19 positive patients confirmed by RT-PCR. Among them, 117 (79.6%) had a history of taking RAAS inhibitor and 30 had history of taking other antihypertensive medications. Of them, two-third patients had more than 50 years of age and more than half of the patients had overweight or obesity. Other than hypertension they had several comorbidities such as Diabetes Mellitus (45.4%), Ischemic Heart Diseases (35.4%), Asthma or COPD (15%) etc. Rate of hospitalization had no statistical difference between RAAS inhibitor group and other hypertensive group (48.7% vs 46.70% respectively; p-value - 0.841). There was no statistical difference between two groups in terms of requirement of oxygen therapy (p-value - 0.297), High Flow Nasal Cannula (p-value - 0.430), intensive care unit (p-value - 0.194) and death (p-value – 0.383) also. Almost half and one-third of the patients had persistence of symptoms even after 14 days and 28 days respectively. Fatigue, cough, breathlessness, loss of appetite and taste were the most common symptoms among those. Conclusion In our study we found that RAAS inhibitor treatment had no adverse effect on the outcome of COVID-19 patients compared with other antihypertensive drugs. Patients may continue receiving ACEIs and ARBs for the treatment of any indication for RAASi without an increased risk of worse outcomes.