Impact of Covid-19 infection in high-risk coronary patients

Carmona, A.; Marchandot, B.; Matsushita, K.; Curtiaud, A.; Elidrissi, A.; Trimaille, A.; Kibler, M.; Cardi, T.; Heger, J.O.E.; Hess, S.; Reydel, A.; Fafi-Kremer, S.; Schini-Kerth, V.; Jesel, L.; Ohlmann, P.; Morel, O.

Background Coronary artery disease (CAD) has been recognized as a major determinant of Covid-19 vulnerability and severity. We sought to compare demographic characteristics, clinical presentation, and outcomes for Covid-19 in a large cohort of chronic CAD patients living in Strasbourg's cluster region (Fig. 1). Methods Follow-up was conducted by telephone interviews performed by cardiologists one month after the start of the French lockdown. The primary outcome was the composite of death or hospitalization related to Covid-19 infection. Secondary endpoints included Covid-19 related death, Covid-19 related hospitalization, intensive care unit (ICU) admission, allcause mortality, cardiovascular (CV) mortality and healthcare compliance. Results Out of 891 patients included, twenty CAD patients (2.2%) had RT-PCR confirmed Covid-19 infection. Confirmed or suspect cases were evidenced in 48 patients (5.4%). Covid-19 patients showed lower left ventricular ejection fraction, were more frequently obese, less likely to smoke or follow lipid lowering therapy. The composite of death or hospitalization related to Covid-19 was 90%. Mortality rate was 30% among confirmed Covid-19 patients. Drugs’ discontinuation rate was low (1.1%) during the confinement. Reticence to consult a healthcare professional occurred in 6.4%. Postponement or cancellation of non-essential medical visits occurred in 15,7% (Table 1). Conclusions Coronary patients from a large French cluster of COVID-19 showed a high risk of Covid-19 infection and worse in-hospital outcomes.