Cardiovascular Comorbidity and its Impact on Patients with COVID-19 in a Tertiary Care Hospital, Bangladesh

Background: People with cardiovascular issues have been shown to be at an elevated risk of acquiring the 2019 new corona virus infection, according to studies (COVID-19). This study’s objective was to determine if cardiovascular disease has any effect on the severity of COVID-19.Material & Methods:Between January 2020 and December 2020, 210 comorbid patients aged over 40 years old diagnosed with COVID-19 admitted in BIRDEM hospital in Bangladesh were recruited purposively for a cross sectional study as per inclusion criteria. A baseline study was created for each patient based on their medical history, physical examination, biochemical tests, and the amount of care they needed (intensive care vs. ward-based care). SPSS 26 was used to analyze the data.Results:Among the 210 comorbid individuals, 74 had cardiovascular comorbidities and the remaining 136 had other comorbidities. Among the respondents, 48% were serious cases and required ICU support within 30 days. Cases with up to 2 comorbidities did not require ICU support. The severity of COVID-19 was predicted by factors such as age above 80 years (OR 35.5, 95 percent CIs 18.7,98.5), male gender (OR 3.14, CI 1.16, 3.50), and a high troponin level in the patient’s blood (OR 1.34, CI 0.84,3.54). It was shown that cardiovascular comorbidities (CI=1.8,3.0) were 2.9 times more likely to be linked to severity. The risk factors also included a history of diabetes, hypertension, and chronic obstructive pulmonary disease. Conclusions:Cardiovascular patients, who were previously grouped together as high risk due to the nature of their ailment, need more tailored counseling and treatment from public health authorities and clinicians.

Health Literacy, Awareness and Self-Efficacy among Cardiovascular Patients Visiting Medical Centers of Shahr-e Kord

@#Introduction: Considering the importance of self-efficacy and since inadequate health literacy can be a serious barrier to the participation and ultimately affect the health of patients. The present research aimed to study the health literacy of cardiovascular patients and its relationship with awareness and self-efficacy. Methods: This research was a descriptive and cross-sectional study which was conducted on 138 cardiovascular patients visiting medical centers of Shahr-e Kord in 2016. The participants were selected using simple random sampling. To assess the health literacy of the participants, TOFHLA was used. The self-efficacy standard questionnaire was applied to measure the self-efficacy of participants. The obtained data were statistically analyzed using descriptive and analytical tests in SPSS-18. Participation in the present study was voluntary. Results: The mean age of participants was equal to 48.59±19.05. Based on the results, 64, 13 and 61 patients had an inadequate, marginal, and adequate level of health literacy, respectively. The mean score of awareness was 68.14±21.68 and the mean score of self-efficacy was obtained 37.90±32.65. There is a direct and significant relationship between awareness, self-efficacy, and health literacy (p=0.000), and awareness is a suitable predictor of health literacy. Conclusion: it is necessary to measure the health literacy and the relevant skills in patients before providing information to them in medical centers. Then, commensurate with their level of information, training programs should be planned to empower patients and increase their self-efficacy, so that they can achieve correct health information.

Interacciones farmacológicas potenciales en pacientes con enfermedad cardiovascular polimedicados / Potential drug interactions in patients with cardiovascular disease and polypharmacy

La enfermedad cardiovascular es la primera causa de morbilidad en la población Venezolana adulta, lo que conduce a un importante número de pacientes hospitalizados que reciben politerapia. De esta situación pueden resultar interacciones farmacológicas (IF). El objetivo del estudio fue evaluar las IF potenciales en pacientes con enfermedades cardiovasculares polimedicados. Para ello se diseñó un estudio de tipo observacional, descriptivo y transversal, se realizó revisión de historias clínicas de 87 pacientes hospitalizados, con un estadío igual o superior a tres días. Para la recolección de datos se empleó un formulario que contenía: número de historia, edad, género, fecha de ingreso y egreso; enfermedad cardiovascular que presentaban; fármacos administrados, fecha de inicio y culminación del tratamiento. La identificación de las IF potenciales se realizó usando el programa TOX MED. Los resultados mostraron edad promedio de 63,82; predominio del género masculino y asociación entre la IF potencial y la prescripción mayor a 7 medicamentos (p=0,002). Las patologías más frecuentes fueron síndrome coronario agudo e hipertensión arterial, y los medicamentos más indicados los agentes antitrombóticos. Se detectaron 519 IF potenciales, 51(30,32%) farmacocinéticas y 347 (69,68%) farmacodinámicas, siendo las más frecuentes las de metabolismo (84,79%) y las de sinergismo (75,79%) respectivamente. El mayor porcentaje de las IF potenciales de origen farmacocinético fue con la asociación atorvastatina - clopidrogel (22,52%) y el de origen farmacodinámico fué con la asociación ácido acetilsalicílico - heparina (15,71%). Se concluye que el número de IF potenciales, farmacocinéticas o farmacodinámicas, aumenta con el número de fármacos que reciben los pacientes.

Cardiovascular disease is the leading cause of morbidity in the adult Venezuelan population, leading to a significant number of hospitalized patients receiving combination therapy, which may cause drug interactions (IF). The aim of this study was to evaluate potential IF polypharmacy in patients with cardiovascular disease. This was an observational, descriptive cross-sectional study; medical records of 87 hospitalized patients were reviewed with a stage of three days or more. The data collection form recorded: history number, age, gender, admission and discharge dates, type of cardiovascular disease; administered drugs, treatment start and completion dates. Identification of potential IF was performed using the TOX MED program. Results showed an average age of 63.82; predominantly males and potential association between IF nd prescription of more than seven drugs (p = 0.002). The most frequent diseases were acute coronary syndrome and hypertension; antithrombotic agents were the most commonly prescribed drugs. 519 IF potential were identified; pharmacokinetic 51 (30.32%) and pharmacodynamic 347 (69.68%), the most frequent ones being metabolism (84.79%) and synergism (75.79%), respectively. The highest percentage of potential pharmacokinetic IF was associated with atorvastatin - clopidogrel (22.52%), and pharmacodynamic with aspirin - heparin (15.71%). It is concluded that the number of pharmacokinetic or pharmacodynamic IF potential increases with the number of drugs that patients take..Key words: Potential drug interactions, drug-drug, cardiovascular patients, polypharmacy.