COVID-19 outcomes in patients with pre-existing cardiovascular disease and risk factors: perspectives from a hospital in Ireland

Deirdre McGuone, Nicola Farrand, Geraldine Prizeman, Frances O'Brien
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Abstract

COVID-19 has led to substantial changes in the provision of emergency healthcare services. International data suggest that COVID-19 is associated with increased morbidity and mortality in patients with pre-existing cardiovascular disease and cardiovascular risk factors. This study aimed to explore the association between pre-existing cardiovascular disease and/or cardiovascular risk factors and COVID-19 disease severity and outcomes in an Irish hospital. This retrospective study obtained data from a bioresource database of patients with confirmed COVID-19 infection (n=649) in a large hospital in Dublin. Data were collected on patients' demographic characteristics, cardiovascular diseases, cardiovascular disease risk factors and medications taken for cardiovascular conditions. The World Health Organization progression scale was used to assess the severity of COVID-19 infection in each patient. Cross-tabulation analysis was used to analyse associations between variables, with a P value of ≤0.05 indicating significance. Mortality rates were six times greater in patients with cardiovascular disease compared to those without cardiovascular disease (18.6% vs 3.1%). A higher percentage of patients with one or more cardiovascular risk factors had moderate (53.4%) or severe (19.1%) COVID-19 and higher mortality rates (10.7%) than those without cardiovascular risk factors. Of the patients who died from COVID-19 (n=40), 60.0% (n=24) had one or more cardiovascular diseases, while 80.0% (n=32) had one or more cardiovascular risk factors. Existing cardiovascular disease and cardiovascular risk factors increase the risk of more severe disease and worse clinical outcomes in patients with COVID-19. Many cardiovascular risk factors are modifiable, so it is important to consider preventative education strategies designed to reduce modifiable risk factors to improve outcomes for patients with COVID-19.
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已有心血管疾病和风险因素的患者的 COVID-19 结果:爱尔兰一家医院的观点
COVID-19 引发了急诊医疗服务的重大变革。国际数据表明,COVID-19 与原有心血管疾病和心血管风险因素患者的发病率和死亡率增加有关。本研究旨在探讨一家爱尔兰医院中已存在的心血管疾病和/或心血管风险因素与 COVID-19 疾病严重程度和结果之间的关联。这项回顾性研究从生物资源数据库中获得了都柏林一家大型医院确诊 COVID-19 感染患者(n=649)的数据。研究收集了患者的人口统计学特征、心血管疾病、心血管疾病风险因素和心血管疾病用药等数据。采用世界卫生组织的进展量表来评估每位患者感染 COVID-19 的严重程度。交叉分析用于分析变量之间的关联,P值≤0.05表示显著性。与无心血管疾病的患者相比,有心血管疾病的患者死亡率高出六倍(18.6% 对 3.1%)。与无心血管风险因素的患者相比,具有一种或多种心血管风险因素的患者中,具有中度(53.4%)或重度(19.1%)COVID-19 的比例更高,死亡率(10.7%)也更高。在死于 COVID-19 的患者(40 人)中,60.0%(24 人)患有一种或多种心血管疾病,而 80.0%(32 人)有一种或多种心血管风险因素。现有的心血管疾病和心血管风险因素会增加 COVID-19 患者病情加重和临床预后恶化的风险。许多心血管风险因素是可以改变的,因此必须考虑旨在减少可改变风险因素的预防教育策略,以改善 COVID-19 患者的预后。
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