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ABSTRACT: Objectives
Recent reports suggest a high prevalence of hypertension and diabetes in COVID-19 patients, but the role of cardiovascular disease (CVD) risk factors in the clinical course of COVID-19 is unknown. We evaluated the time-to-event relationship between hypertension, dyslipidaemia, diabetes and COVID-19 outcomes.Design
We analysed data from the prospective Dutch CovidPredict cohort, an ongoing prospective study of patients admitted for COVID-19 infection.Setting
Patients from eight participating hospitals, including two university hospitals from the CovidPredict cohort were included.Participants
Admitted, adult patients with a positive COVID-19 PCR or high suspicion based on CT-imaging of the thorax. Patients were followed for major outcomes during the hospitalisation. CVD risk factors were established via home medication lists and divided in antihypertensives, lipid-lowering therapy and antidiabetics.Primary and secondary outcomes measures
The primary outcome was mortality during the first 21 days following admission, secondary outcomes consisted of intensive care unit (ICU) admission and ICU mortality. Kaplan-Meier and Cox regression analyses were used to determine the association with CVD risk factors.Results
We included 1604 patients with a mean age of 66±15 of whom 60.5% were men. Antihypertensives, lipid-lowering therapy and antidiabetics were used by 45%, 34.7% and 22.1% of patients. After 21-days of follow-up; 19.2% of the patients had died or were discharged for palliative care. Cox regression analysis after adjustment for age and sex showed that the presence of ?2?risk factors was associated with increased mortality risk (HR 1.52, 95%?CI 1.15 to 2.02), but not with ICU admission. Moreover, the use of ?2 antidiabetics and ?2 antihypertensives was associated with mortality independent of age and sex with HRs of, respectively, 2.09 (95% CI 1.55 to 2.80) and 1.46 (95% CI 1.11 to 1.91).Conclusions
The accumulation of hypertension, dyslipidaemia and diabetes leads to a stepwise increased risk for short-term mortality in hospitalised COVID-19 patients independent of age and sex. Further studies investigating how these risk factors disproportionately affect COVID-19 patients are warranted.
SUBMITTER: Collard D
PROVIDER: S-EPMC7902321 | biostudies-literature | 2021 Feb
REPOSITORIES: biostudies-literature
Collard Didier D Nurmohamed Nick S NS Kaiser Yannick Y Reeskamp Laurens F LF Dormans Tom T Moeniralam Hazra H Simsek Suat S Douma Renee R Eerens Annet A Reidinga Auke C AC Elbers Paul W G PWG Beudel Martijn M Vogt Liffert L Stroes Erik S G ESG van den Born Bert-Jan H BH
BMJ open 20210222 2
<h4>Objectives</h4>Recent reports suggest a high prevalence of hypertension and diabetes in COVID-19 patients, but the role of cardiovascular disease (CVD) risk factors in the clinical course of COVID-19 is unknown. We evaluated the time-to-event relationship between hypertension, dyslipidaemia, diabetes and COVID-19 outcomes.<h4>Design</h4>We analysed data from the prospective Dutch CovidPredict cohort, an ongoing prospective study of patients admitted for COVID-19 infection.<h4>Setting</h4>Pat ...[more]