Chronic Cardio‐Metabolic Disease Increases the Risk of Worse Outcomes Among Hospitalized Patients With COVID‐19: A Multicenter, Retrospective, and Real‐World Study

Chen, Qijian; Wang, Lingling; Li, Chang; Hu, Weihua; Fan, Yameng; Chen, Zaishu; Wu, Longlong; Lu, Zhanjin; Ye, Jianfang; Chen, Shiyan; Tong, Junlu; Ruan, Liemin; Mei, Jin; Lu, Hongyun

BACKGROUND: Although chronic cardio‐metabolic disease is a common comorbidity among patients with COVID‐19, its effects on the clinical characteristics and outcome are not well known. METHODS AND RESULTS: This study aimed to explore the association between underlying cardio‐metabolic disease and mortality with COVID‐19 among hospitalized patients. This multicenter, retrospective, and real‐world study was conducted from January 22, 2020 to March 25, 2020 in China. Data between patients with and without 5 main cardio‐metabolic diseases including hypertension, diabetes mellitus, coronary heart disease, cerebrovascular disease, and hyperlipidemia were compared. A total of 1303 hospitalized patients were included in the final analysis. Of them, 520 patients (39.9%) had cardio‐metabolic disease. Compared with patients without cardio‐metabolic disease, more patients with cardio‐metabolic disease had COVID‐related complications including acute respiratory distress syndrome (9.81% versus 3.32%; P<0.001), acute kidney injury (4.23% versus 1.40%; P=0.001), secondary infection (13.9% versus 9.8%; P=0.026), hypoproteinemia (12.1% versus 5.75%; P<0.001), and coagulopathy (19.4% versus 10.3%; P<0.001), had higher incidences of the severe type of COVID‐19 (32.9% versus 16.7%; P<0.001), more were admitted to the intensive care unit (11.7% versus 7.92%; P=0.021), and required mechanical ventilation (9.8% versus 4.3%; P<0.001). When the number of the patients' cardio‐metabolic diseases was 0, 1, and >2, the mortality was 4.2%, 11.1%, and 19.8%, respectively. The multivariable‐adjusted hazard ratio of mortality among patients with cardio‐metabolic disease was 1.80 (95% CI, 1.17–2.77). CONCLUSIONS: Cardio‐metabolic disease was a common condition among hospitalized patients with COVID‐19, and it was associated with higher risks of in‐hospital mortality.