Cardiovascular comorbidities as predictors for severe COVID-19 infection or death
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Cardiovascular comorbidities as predictors for severe COVID-19 infection or death. / Phelps, Matthew; Christensen, Daniel Molager; Gerds, Thomas; Fosbøl, Emil; Torp-Pedersen, Christian; Schou, Morten; Køber, Lars; Kragholm, Kristian; Andersson, Charlotte; Biering-Sorensen, Tor; Christensen, Helle Collatz; Andersen, Mikkel Porsborg; Gislason, Gunnar.
I: European Heart Journal - Quality of Care and Clinical Outcomes, Bind 7, Nr. 2, 2021, s. 172-180.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Cardiovascular comorbidities as predictors for severe COVID-19 infection or death
AU - Phelps, Matthew
AU - Christensen, Daniel Molager
AU - Gerds, Thomas
AU - Fosbøl, Emil
AU - Torp-Pedersen, Christian
AU - Schou, Morten
AU - Køber, Lars
AU - Kragholm, Kristian
AU - Andersson, Charlotte
AU - Biering-Sorensen, Tor
AU - Christensen, Helle Collatz
AU - Andersen, Mikkel Porsborg
AU - Gislason, Gunnar
PY - 2021
Y1 - 2021
N2 - Aims Pre-existing cardiovascular diseases (CVDs) have been proposed to identify patients at higher risk of adverse coronavirus disease 2019 (COVID-19) outcomes, but existing evidence is conflicting. Thus, it is unclear whether pre-existing CVDs are independently important predictors for severe COVID-19.Methods and results In a nationwide Danish cohort of hospital-screened COVID-19 patients aged >= 40, we investigated if pre-existing CVDs predict the 30-day risk of (i) composite outcome of severe COVID-19 and (ii) all-cause mortality. We estimated 30-day risks using a Cox regression model including age, sex, each CVD comorbidity, chronic obstructive pulmonary disease-asthma, diabetes, and chronic kidney disease. To illustrate CVD comorbidities' importance, we evaluated the predicted risks of death and severe infection, for each sex, along ages 40-85. In total, 4090 COVID-19 hospital-screened patients were observed as of 26 August 2020; 22.1% had >= 1 CVD, 23.7% had severe infection within 30days and 12.6% died. Predicted risks of both outcomes at age 75 among men with single CVD comorbidities did not differ in clinically meaningful amounts compared with men with no comorbidities risks for the composite outcome of severe infection; women with heart failure (28.2%; 95% CI 21.1-37.0%) or atrial fibrillation (30.0%; 95% CI: 24.2-36.9%) showed modest increases compared with women with no comorbidities (24.0%; 95% CI: 21.4-26.9%).Conclusions The results showing only modest effects of CVDs on increased risks of poor COVID-19 outcomes are important in allowing public health authorities and clinicians to provide more tailored guidance to cardiovascular patients, who have heretofore been grouped together as high risk due to their disease status.YY
AB - Aims Pre-existing cardiovascular diseases (CVDs) have been proposed to identify patients at higher risk of adverse coronavirus disease 2019 (COVID-19) outcomes, but existing evidence is conflicting. Thus, it is unclear whether pre-existing CVDs are independently important predictors for severe COVID-19.Methods and results In a nationwide Danish cohort of hospital-screened COVID-19 patients aged >= 40, we investigated if pre-existing CVDs predict the 30-day risk of (i) composite outcome of severe COVID-19 and (ii) all-cause mortality. We estimated 30-day risks using a Cox regression model including age, sex, each CVD comorbidity, chronic obstructive pulmonary disease-asthma, diabetes, and chronic kidney disease. To illustrate CVD comorbidities' importance, we evaluated the predicted risks of death and severe infection, for each sex, along ages 40-85. In total, 4090 COVID-19 hospital-screened patients were observed as of 26 August 2020; 22.1% had >= 1 CVD, 23.7% had severe infection within 30days and 12.6% died. Predicted risks of both outcomes at age 75 among men with single CVD comorbidities did not differ in clinically meaningful amounts compared with men with no comorbidities risks for the composite outcome of severe infection; women with heart failure (28.2%; 95% CI 21.1-37.0%) or atrial fibrillation (30.0%; 95% CI: 24.2-36.9%) showed modest increases compared with women with no comorbidities (24.0%; 95% CI: 21.4-26.9%).Conclusions The results showing only modest effects of CVDs on increased risks of poor COVID-19 outcomes are important in allowing public health authorities and clinicians to provide more tailored guidance to cardiovascular patients, who have heretofore been grouped together as high risk due to their disease status.YY
KW - COVID-19
KW - Mortality
KW - Morbidity
KW - Severe outcomes
KW - Cardiovascular comorbidities
KW - Pre-existing conditions
KW - EPIDEMIOLOGY
U2 - 10.1093/ehjqcco/qcaa081
DO - 10.1093/ehjqcco/qcaa081
M3 - Journal article
C2 - 33107909
VL - 7
SP - 172
EP - 180
JO - European Heart Journal - Quality of Care and Clinical Outcomes
JF - European Heart Journal - Quality of Care and Clinical Outcomes
SN - 2058-5225
IS - 2
ER -
ID: 261661419