History of Coronary Heart Disease Increases the Mortality Rate of Coronavirus Disease 2019 (COVID-19) Patients: A Nested Case-Control Study Based on Publicly Reported Confirmed Cases in Mainland China

Tian Gu; Qiao Chu; Zhangsheng Yu; Botao Fa; Anqi Li; Lei Xu; Ruijun Wu; Yaping He

Previous studies have indicated that cardiovascular events following pneumonia may increase the risk of mortality [35] [36] [37] [38] [39] [40] [41] , which explained our findings from the point view of pathophysiological mechanisms. One potential mechanism underlying the association between pneumonia and cardiovascular events is inflammation [38] . Specifically, the inflammatory reaction following pneumonia can result in plague instability and damage in the blood vessels, where evidence of elevated local inflammation in the atherosclerotic coronary arteries following acute systemic infections have been shown in many studies [38, 40] . Thus, infections may result in heightened loading imposed on cardiomyocytes, and lead to sympathetic hyperactivity, ischemia, which may increase the risk of arrhythmia and heart failure in COVID-19 patients with pre-existing CHD [37] .