Outcomes and Risk Factors for Cardiovascular Events in Hospitalized COVID-19 Patients

Xu, Qian; Samanapally, Harideep; Nathala, Pavani; Salunkhe, Vidyulata; Furmanek, Stephen; Cahill, Meredith N.; McGuffin, Trevor; Mohammad, Tahboub; Marsili, Bradford; Petrey, Jessica; Carrico, Ruth; Ramirez, Julio; Akca, Ozan; Clifford, Sean P.; Pahwa, Siddharth; Roser, Lynn; Kong, Maiying; Huang, Jiapeng

OBJECTIVE: To analyze outcomes and risk factors of cardiovascular events in a metropolitan COVID-19 database, and to perform a subgroup analysis in African American populations to determine whether outcomes and risk factors are influenced by race. DESIGN: Retrospective cohort analysis from March 9, 2020 to June 20, 2020. SETTING: Population-based study in Louisville, KY, USA PARTICIPANTS: 700 adult inpatients hospitalized with COVID-19. INTERVENTIONS: N/A MEASUREMENTS AND MAIN: Results: Our cohort consisted of 126 patients (18%) with cardiovascular events and 574 patients without cardiovascular events. Patients with cardiovascular events had a much higher mortality rate than those without cardiovascular events (45.2% vs. 8.7%, p<0.001). There was no difference between African Americans and Whites regarding mortality (43.9% vs 46.3%, p=1) and length of stay for survivors (11 days vs. 9.5 days, p=0.301). Multiple logistics regression analysis suggested that male, race, lower SaO2/FiO2, higher serum potassium, lower serum albumin, and number of cardiovascular co-morbidities were highly associated with the occurrence of cardiovascular events in COVID-19 patients. Lower serum albumin and neoplastic/immune compromised diseases were highly associated with cardiovascular events for African American COVID-19 patients. SaO2/FiO2 ratio and cardiovascular comorbidity count were significantly associated with cardiovascular events in white patients. CONCLUSIONS: : Cardiovascular events were prevalent and associated with worse outcomes in hospitalized patients with COVID-19. Outcomes of cardiovascular events in African American and white COVID-19 patients were similar after propensity score matching analysis. There were common and unique risk factors for cardiovascular events in African American COVID-19 patients when compared with white patients.