A Population-Based Registry Analysis on Hospitalized COVID-19 Patients with Previous Cardiovascular Disease: Clinical Profile, Treatment, and Predictors of Death

Abstract

A high percentage of patients with COVID-19 (coronavirus disease 2019) have previous cardiovascular disease (CVD). The findings presented here came from an epidemiological population-based registry study (real-world data) that enrolled all in-hospital COVID-19 patients with previous CVD from 1 March to 31 May 2020. Death, other comorbidities, hospital stay variables, ventilation type, and main clinical outcomes were evaluated. In Castile and Leon, 35.83% of the 7307 in-hospital COVID-19 patients who participated in this study had previous CVD, particularly arrhythmias (48.97%), cerebrovascular disease (25.02%), ischemic heart disease (22.8%), and chronic heart failure (20.82%). Of the patients, 21.36% were men and more than 90% were over 65 years of age, and the mortality rate achieved 32.93%. The most used medicines were antibiotics (91.41%), antimalarials (73.3%), steroids (46.64%), and antivirals (43.16%). The main predictors of death were age over 65 years (OR: 5), ventilation needs (OR: 2.81), treatment with anti-SIRS (systemic inflammatory response syndrome) medicines (OR: 1.97), antivirals (OR: 1.74) or steroids (OR: 1.68), SIRS (OR: 5.75), SARS (severe acute respiratory syndrome) (OR: 2.44), or AKI (acute kidney injury) (OR: 1.63) occurrence. Chronic heart failure and cerebrovascular disease were associated with a worse clinical course of COVID-19, especially in men older than 65 years with diabetes who developed SIRS, SARS, or AKI.

Hospitalized COVID-19 Patients with Severe Acute Respiratory Syndrome: A Population-Based Registry Analysis to Assess Clinical Findings, Pharmacological Treatment and Survival

“…Furthermore, tocilizumab and steroids were associated with a low rate of hospital death, which confirm them today the main treatment for SARS in patients hospitalized for COVID-19. Finally, the findings of this study, combined with those previously reported for other clinical conditions with bad prognosis in hospitalized COVID-19 patients (AKI [13] and previous CVD [14]), are decisive for the early detection of patients at risk, to determine the main predictors of mortality and to establish a protocol for clinical and pharmacological management based on previous experience.…”

“…In this regard, the main aim of this study is to provide realworld data about in-hospital COVID-19 patients affected by SARS in our region, the largest of Spain, with 2,323,770 inhabitants and a network hospital capacity of 7141 beds spread over 14 hospitals (three regional hospitals, six general hospitals and five first-level referral hospitals). As a continuation of previously conducted research [3,13,14], this manuscript presents an analysis of patterns of drug use, survival, mortality rate and main predictors of mortality among the patients described above. These results complete the in-depth analysis of clinical conditions with worse prognosis for hospitalized COVID-19 patients, such as SARS, acute kidney injury (AKI) [13] and previous cardiovascular disease (CVD) [14].…”

“…As a continuation of previously conducted research [3,13,14], this manuscript presents an analysis of patterns of drug use, survival, mortality rate and main predictors of mortality among the patients described above. These results complete the in-depth analysis of clinical conditions with worse prognosis for hospitalized COVID-19 patients, such as SARS, acute kidney injury (AKI) [13] and previous cardiovascular disease (CVD) [14].…”

Usefulness of C2HEST Score in Predicting Clinical Outcomes of COVID-19 in Heart Failure and Non-Heart-Failure Cohorts

“…Since the outbreak of the global COVID-19 pandemic, numerous risk factors of SARS-CoV-2 infection severity have been described [ 1 , 2 ]. Even though several scoring systems [ 3 ] have been proposed, the clinical course among individuals with COVID-19 is still unpredictable.…”