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Impact of cardiometabolic multimorbidity and ethnicity on cardiovascular/renal complications in patients with COVID-19.
Norris, Tom; Razieh, Cameron; Zaccardi, Francesco; Yates, Thomas; Islam, Nazrul; Gillies, Clare L; Chudasama, Yogini V; Rowlands, Alex V; Davies, Melanie J; McCann, Gerry P; Banerjee, Amitava; Lam, Carolyn S P; Docherty, Annemarie B; Openshaw, Peter Jm; Baillie, J Kenneth; Semple, Malcolm Gracie; Lawson, Claire Alexandra; Khunti, Kamlesh.
  • Norris T; Leicester Real World Evidence Unit, Leicester General Hospital, Leicester, UK tdn9@leicester.ac.uk.
  • Razieh C; Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK.
  • Zaccardi F; Leicester Real World Evidence Unit, Leicester General Hospital, Leicester, UK.
  • Yates T; Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK.
  • Islam N; Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK.
  • Gillies CL; Big Data Institute, University of Oxford, Oxford, Oxfordshire, UK.
  • Chudasama YV; Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK.
  • Rowlands AV; Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK.
  • Davies MJ; Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK.
  • McCann GP; Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK.
  • Banerjee A; Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
  • Lam CSP; Farr Institute of Health Informatics Research, University College London, London, UK.
  • Docherty AB; Department of Cardiology, National Heart Centre Singapore, Singapore.
  • Openshaw PJ; Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, Edinburgh, UK.
  • Baillie JK; Imperial College London, London, UK.
  • Semple MG; The Roslin Institute, The University of Edinburgh, Easter Bush Campus, Midlothian, UK.
  • Lawson CA; University of Liverpool, Liverpool, UK.
  • Khunti K; Leicester Real World Evidence Unit, Leicester General Hospital, Leicester, UK.
Heart ; 2021 Dec 15.
Article in English | MEDLINE | ID: covidwho-1583068
ABSTRACT

OBJECTIVE:

Using a large national database of people hospitalised with COVID-19, we investigated the contribution of cardio-metabolic conditions, multi-morbidity and ethnicity on the risk of in-hospital cardiovascular complications and death.

METHODS:

A multicentre, prospective cohort study in 302 UK healthcare facilities of adults hospitalised with COVID-19 between 6 February 2020 and 16 March 2021. Logistic models were used to explore associations between baseline patient ethnicity, cardiometabolic conditions and multimorbidity (0, 1, 2, >2 conditions), and in-hospital cardiovascular complications (heart failure, arrhythmia, cardiac ischaemia, cardiac arrest, coagulation complications, stroke), renal injury and death.

RESULTS:

Of 65 624 patients hospitalised with COVID-19, 44 598 (68.0%) reported at least one cardiometabolic condition on admission. Cardiovascular/renal complications or death occurred in 24 609 (38.0%) patients. Baseline cardiometabolic conditions were independently associated with increased odds of in-hospital complications and this risk increased in the presence of cardiometabolic multimorbidity. For example, compared with having no cardiometabolic conditions, 1, 2 or ≥3 conditions was associated with 1.46 (95% CI 1.39 to 1.54), 2.04 (95% CI 1.93 to 2.15) and 3.10 (95% CI 2.92 to 3.29) times higher odds of any cardiovascular/renal complication, respectively. A similar pattern was observed for all-cause death. Compared with the white group, the South Asian (OR 1.19, 95% CI 1.10 to 1.29) and black (OR 1.53 to 95% CI 1.37 to 1.72) ethnic groups had higher risk of any cardiovascular/renal complication.

CONCLUSIONS:

In hospitalised patients with COVID-19, cardiovascular complications or death impacts just under half of all patients, with the highest risk in those of South Asian or Black ethnicity and in patients with cardiometabolic multimorbidity.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Randomized controlled trials / Risk factors Language: English Journal subject: Cardiology Year: 2021 Document Type: Article Affiliation country: HEARTJNL-2021-320047

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Randomized controlled trials / Risk factors Language: English Journal subject: Cardiology Year: 2021 Document Type: Article Affiliation country: HEARTJNL-2021-320047