Association between Cardiovascular Burden and Requirement of Intensive Care among Patients with Mild COVID-19

Tai, S.; Tang, J.; Yu, B.; Tang, L.; Wang, Y.; Zhang, H.; Zhu, W.; Xiao, K.; Wen, C.; Tan, C.; Jiang, Z.; Jiang, C.; Zhu, L.; Jiang, L.; Liu, Q.; Hu, X.; Fang, Z.; Li, X.; Sun, J.; Zhu, Z.; Yang, H.; Tu, T.; Xiao, Y.; Chen, M.; He, Y.; Chai, X.; Xu, J.; Zhou, S.

Background: Information regarding the impact of cardiovascular disease (CVD) on disease progression among patients with mild coronavirus disease 2019 (COVID-19) is limited. Methods: This study evaluated the association of underlying CVD with disease progression in patients with mild COVID-19. The primary outcome was the need to be transferred to intensive care due to disease progression. The patients were divided with and without CVD as well as stable and intensive care groups. Results: Of 332 patients with mild COVID-19, median age was 51 years (IQR, 40-59 years), and 200 (61.2%) were female. Of 48 (14.5%) patients with CVD, 23 (47.9%) progressed to severe disease status and required intensive care. Compared with patients without CVD, patients with CVD were older, and more likely to have fatigue, chest tightness, and myalgia. The rate of requiring intensive care was significantly higher among patients with CVD than in patients without CVD (47.92% vs. 12.4%; P<0.001). In subgroup analysis, rate of requiring intensive care was also higher among patients with either hypertension or coronary heart disease than in patients without hypertension or coronary heart disease. The multivariable regression model showed CVD served as an independent risk factor for intensive care (Odd ratio [OR], 2.652 [95% CI, 1.019-6.899]) after adjustment for various cofounders. Conclusions: Patients with mild COVID-19 complicating CVD in are susceptible to develop severe disease status and requirement for intensive care.