Vol 28, No 3 (2021)
Original Article
Published online: 2021-03-10

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Impact of the presence of heart disease, cardiovascular medications and cardiac events on outcome in COVID-19

Gonzalo Cabezón Villalba1, Ignacio J. Amat-Santos1, Carlos Dueñas2, Diego Lopez Otero3, Pablo Catala1, Alvaro Aparisi1, Javier López-Pais3, Carla Eugenia Cacho Antonio3, Jordi Candela1, Pablo Antúnez Muiños3, Jose Francisco Gil1, Teba Gonzalez Ferrero3, Marta Marcos1, Marta Pérez-Poza3, Gino Rojas1, Oscar Otero Garcia3, Carlos Veras1, Victor Jiménez Ramos3, Aitor Uribarri1, Ana Revilla1, Pablo Elpidio Garcia-Granja1, Itziar Gómez1, José Ramón González-Juanatey3, J. Alberto San Román1
Pubmed: 33843043
Cardiol J 2021;28(3):360-368.


Background: Cardiovascular risk factors and usage of cardiovascular medication are prevalent among coronavirus disease 2019 (COVID-19) patients. Little is known about the cardiovascular implications of COVID-19. The goal herein, was to evaluate the prognostic impact of having heart disease (HD) and taking cardiovascular medications in a population diagnosed of COVID-19 who required hospitalization. Also, we studied the development of cardiovascular events during hospitalization.

Methods: Consecutive patients with definitive diagnosis of COVID-19 made by a positive real time- -polymerase chain reaction of nasopharyngeal swabs who were admitted to the hospital from March 15 to April 14 were included in a retrospective registry. The association of HD with mortality and with mortality or respiratory failure were the primary and secondary objectives, respectively.

Results: A total of 859 patients were included in the present analysis. Cardiovascular risk factors were related to death, particularly diabetes mellitus (hazard ratio in the multivariate analysis: 1.810 [1.159– –2.827], p = 0.009). A total of 113 (13.1%) patients had HD. The presence of HD identified a group of patients with higher mortality (35.4% vs. 18.2%, p < 0.001) but HD was not independently related to prognosis; renin–angiotensin–aldosterone system inhibitors, calcium channel blockers, diuretics and beta-blockers did not worsen prognosis. Statins were independently associated with decreased mortality (0.551 [0.329–0.921], p = 0.023). Cardiovascular events during hospitalization identified a group of patients with poor outcome (mortality 31.8% vs. 19.3% without cardiovascular events, p = 0.007).

Conclusions: The presence of HD is related to higher mortality. Cardiovascular medications taken before admission are not harmful, statins being protective. The development of cardiovascular events during the course of the disease is related to poor outcome.

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