Cardiovascular Risk Factors and Outcomes in COVID-19: Hospital-Based Prospective Study in India

Sharma, A. K.; Baig, V. N.; Sharma, S.; Dalela, G.; Panwar, R. B.; Katoch, V. M.; Gupta, R.

Background & Objectives: Presence of cardiovascular (CV) risk factors enhance adverse outcomes in COVID-19. To determine association of risk factors with clinical outcomes in India we performed a study. Methods: Successive virologically confirmed patients of COVID-19 at a government hospital were recruited at admission and in-hospital outcome and other details obtained. The cohort was classified according to age, sex, hypertension, diabetes and tobacco use. To compare intergroup outcomes we performed univariate and multivariate logistic regression. Results: From March-September 2020 we recruited 4645 (men 3386, women 1259) out of 5103 COVID-19 patients (91.0%). Mean age was 46+18y, hypertension was in 17.8%, diabetes in 16.6% and tobacco-use in 29.5%. Duration of hospital stay was 6.8+3.7 days, supplemental oxygen was in 18.4%, non-invasive ventilation in 7.1%, mechanical ventilation in 3.6% and 7.3% died. Unadjusted and age-sex adjusted odds ratio and 95% confidence intervals, respectively were, age >50y (4.16, 3.22-5.37 and 4.15,3.21-5.35), men (1.88,1.41-2.51 and 1.26,0.91-1.48); hypertension (2.22,1.74-2.83 and 1.32,1.02-1.70), diabetes (1.88,1.46-2.43 and 1.16,0.89-1.52) and tobacco (1.29,1.02-1.63 and 1.28,1.00-1.63). Need for invasive ventilation was greater in age >50y (3.06,2.18-4.28 and 3.06,2.18-4.29) and diabetes (1.64,1.14-2.35 and 1.12,0.77-1.62). Non-invasive ventilation was more in age >50y (2.27,1.80-2.86 and 2.26,1.79-2.85) and hypertension (1.82,1.41-2.35 and 1.29,0.99-1.69). Multivariate adjustment for presenting factors attenuated the significance. Conclusion: Cardiovascular risk factors- age, male sex, hypertension, diabetes and tobacco- are associated with greater risk of death and adverse outcomes in COVID-19 patients in India.