Section 3: Cardiovascular Comorbidities and COVID-19 Outcomes (from DOI: 10.1007/s11886-020-01293-2)
From publication: "Cardiovascular Risks in Patients with COVID-19: Potential Mechanisms and Areas of Uncertainty" published as Curr Cardiol Rep; 2020 04 29 ; 22 (5) 34. DOI: https://doi.org/10.1007/s11886-020-01293-2
Section 3: Cardiovascular Comorbidities and COVID-19 Outcomes
Recent epidemiological studies in China have reported a heightened risk of COVID-19 related complications in patients with pre-existing cardiovascular diseases and relevant risk factors (Table 1) . While variabilities exist among reported studies, rates of hypertension, diabetes mellitus, and coronary heart disease appear to be higher among those with worse outcomes from COVID-19. Most notably, Guan et al. pooled data of laboratory confirmed 1099 COVID-19 patients from 552 hospitals in 30 provinces in China through January 2020 and found that rates of hypertension (23.7% vs 13.4%) and diabetes (15.2% vs 5.7%) were significantly higher among patients with severe vs non-severe pneumonia. A similar trend existed regarding primary endpoints defined as admission to an intensive care unit, the use of mechanical ventilation, or death (35.8% vs 13.7% for hypertension, 26.9% vs 6.1% for diabetes). Active smoking, which has adverse effects on both cardio and pulmonary systems, was also associated with worse composite outcomes (25.8% vs 11.8%). While overall rates were low, pre-existing coronary heart disease was also more prevalent among those with a severe form of pneumonia (5.8% vs 1.8%). These findings were replicated in several additional studies (Table 1). However, these results were not adjusted for age or other relevant variables and therefore caution is needed when interpreting these results. Additionally, it is unclear if being more ill affected the accuracy of documented risk factors, as the overall incidences of hypertension and smoking observed are significantly lower than those seen in other large general Chinese cohort studies. While limited, preliminary data from the USA and Italy also suggest higher prevalence of underlying cardiovascular diseases in patients with poor outcomes.