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COVID-19 associated mortality and cardiovascular disease outcomes among US women veterans.
Tsai, Shirling; Nguyen, Hang; Ebrahimi, Ramin; Barbosa, Monica R; Ramanan, Bala; Heitjan, Daniel F; Hastings, Jeffrey L; Modrall, J Gregory; Jeon-Slaughter, Haekyung.
  • Tsai S; Veterans Affairs North Texas Health Care System, Dallas, TX, USA.
  • Nguyen H; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
  • Ebrahimi R; Veterans Affairs North Texas Health Care System, Dallas, TX, USA.
  • Barbosa MR; Southern Methodist University, Dallas, TX, USA.
  • Ramanan B; Veterans Affairs Greater Los Angeles Health Care System, Los Angeles, CA, USA.
  • Heitjan DF; Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA.
  • Hastings JL; Veterans Affairs North Texas Health Care System, Dallas, TX, USA.
  • Modrall JG; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
  • Jeon-Slaughter H; Veterans Affairs North Texas Health Care System, Dallas, TX, USA.
Sci Rep ; 11(1): 8497, 2021 04 19.
Article in English | MEDLINE | ID: covidwho-1193603
Semantic information from SemMedBD (by NLM)
1. Cardiovascular LOCATION_OF Disease Outcome
Subject
Cardiovascular
Predicate
LOCATION_OF
Object
Disease Outcome
2. Disease Outcome PROCESS_OF Veterans
Subject
Disease Outcome
Predicate
PROCESS_OF
Object
Veterans
3. COVID-19 PROCESS_OF Woman
Subject
COVID-19
Predicate
PROCESS_OF
Object
Woman
4. Pharmaceutical Preparations TREATS Chronic Obstructive Airway Disease
Subject
Pharmaceutical Preparations
Predicate
TREATS
Object
Chronic Obstructive Airway Disease
5. Antiplatelet TREATS Chronic Obstructive Airway Disease
Subject
Antiplatelet
Predicate
TREATS
Object
Chronic Obstructive Airway Disease
6. Body mass index procedure DIAGNOSES 2 years
Subject
Body mass index procedure
Predicate
DIAGNOSES
Object
2 years
7. American College of Cardiology/American Heart Association Lesion Complexity Score A PROCESS_OF Veterans
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score A
Predicate
PROCESS_OF
Object
Veterans
8. American College of Cardiology/American Heart Association Lesion Complexity Score C PROCESS_OF Veterans
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score C
Predicate
PROCESS_OF
Object
Veterans
9. COVID-19 PROCESS_OF Veterans
Subject
COVID-19
Predicate
PROCESS_OF
Object
Veterans
10. Cardiovascular LOCATION_OF Disease Outcome
Subject
Cardiovascular
Predicate
LOCATION_OF
Object
Disease Outcome
11. Disease Outcome PROCESS_OF Veterans
Subject
Disease Outcome
Predicate
PROCESS_OF
Object
Veterans
12. COVID-19 PROCESS_OF Woman
Subject
COVID-19
Predicate
PROCESS_OF
Object
Woman
13. Pharmaceutical Preparations TREATS Chronic Obstructive Airway Disease
Subject
Pharmaceutical Preparations
Predicate
TREATS
Object
Chronic Obstructive Airway Disease
14. Antiplatelet TREATS Chronic Obstructive Airway Disease
Subject
Antiplatelet
Predicate
TREATS
Object
Chronic Obstructive Airway Disease
15. Body mass index procedure DIAGNOSES 2 years
Subject
Body mass index procedure
Predicate
DIAGNOSES
Object
2 years
16. American College of Cardiology/American Heart Association Lesion Complexity Score A PROCESS_OF Veterans
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score A
Predicate
PROCESS_OF
Object
Veterans
17. American College of Cardiology/American Heart Association Lesion Complexity Score C PROCESS_OF Veterans
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score C
Predicate
PROCESS_OF
Object
Veterans
18. COVID-19 PROCESS_OF Veterans
Subject
COVID-19
Predicate
PROCESS_OF
Object
Veterans
ABSTRACT
The burden of COVID-19 has been noted to be disproportionately greater in minority women, a population that is nevertheless still understudied in COVID-19 research. We conducted an observational study to examine COVID-19-associated mortality and cardiovascular disease outcomes after testing (henceforth index) among a racially diverse adult women veteran population. We assembled a retrospective cohort from a Veterans Affairs (VA) national COVID-19 shared data repository, collected between February and August 2020. A case was defined as a woman veteran who tested positive for SARS-COV-2, and a control as a woman veteran who tested negative. We used Kaplan-Meier curves and the Cox proportional hazards model to examine the distribution of time to death and the effects of baseline predictors on mortality risk. We used generalized linear models to examine 60-day cardiovascular disease outcomes. Covariates studied included age, body mass index (BMI), and active smoking status at index, and pre-existing conditions of diabetes, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), and a history of treatment with antiplatelet or anti-thrombotic drug at any time in the 2 years prior to the index date. Women veterans who tested positive for SARS-CoV-2 had 4 times higher mortality risk than women veterans who tested negative (Hazard Ratio 3.8, 95% Confidence Interval CI 2.92 to 4.89) but had lower risk of cardiovascular events (Odds Ratio OR 0.78, 95% CI 0.66 to 0.92) and developing new heart disease conditions within 60 days (OR 0.67, 95% CI 0.58 to 0.77). Older age, obesity (BMI > 30), and prior CVD and COPD conditions were positively associated with increased mortality in 60 days. Despite a higher infection rate among minority women veterans, there was no significant race difference in mortality, cardiovascular events, or onset of heart disease. SARS-CoV-2 infection increased short-term mortality risk among women veterans similarly across race groups. However, there was no evidence of increased cardiovascular disease incidence in 60 days. A longer follow-up of women veterans who tested positive is warranted.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Cardiovascular Diseases / COVID-19 Type of study: Etiology study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Adult / Female / Humans / Middle aged Language: English Journal: Sci Rep Year: 2021 Document Type: Article Affiliation country: S41598-021-88111-z

Full text: Available Collection: International databases Database: MEDLINE Main subject: Cardiovascular Diseases / COVID-19 Type of study: Etiology study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Adult / Female / Humans / Middle aged Language: English Journal: Sci Rep Year: 2021 Document Type: Article Affiliation country: S41598-021-88111-z