In-hospital outcomes of COVID-19 infection in patients with underlying cardiovascular disease

Changal, Khalid; Mack, Sean; Veria, Spiro; Paternite, David; Bashir, Rehana; Patel, Mitra; Ali, Muhammad; Nazir, Salik; Mir, Tanveer; Sheikh, Mujeeb; Ramanathan, P Kasi

BACKGROUND: The effects of cardiovascular comorbidities on outcomes in COVID-19 hospitalized patients has not been well studied. METHODS: This is a hospital-based study evaluating the effects of CVD on the outcomes in patients admitted with COVID-19. Clinical outcomes were studied in patients with and without CVD. RESULTS: Eighty-seven patients had CVD, and 193 patients had no history of CVD. Ischemic heart disease was the most common CVD (63%). When compared with patients with no CVD, those with CVD had higher mortality (29% vs 9%, p < 0.001), discharge to a skilled nursing facility (SNF) (36% vs 15%, p < 0.001), and change of code status to 'do not resuscitate' (41% vs 14%, p < 0.001). The odds for mortality were high with ischemic heart disease (OR 3.6, 95% CI 1.8-7.3, p < 0.001), and systolic heart failure (OR 3.8,95% CI 1.2-12.3, p = 0.02). Patients in the CVD group were more likely to have incident atrial fibrillation (22% vs 3%, p < 0.001), type 2 Mi (17% vs 6%, p = 0.002), high BNP (57% vs 14%, p < 0.001), acute kidney injury (64% vs 29%, p < 0.001), and any type of circulatory shock (27% vs 12%, p = 0.001). CONCLUSION: CVD is associated with increased mortality, myocardial injury, arrhythmias, and discharges to an SNF.