Key result
Among COVID-19 patients with cardiovascular diseases, acute coronary syndrome was the most common manifestation (50.7%), and in-hospital mortality occurred in 18.9% of patients.
Why the study?
The pattern of cardiovascular diseases in COVID-19 patients admitted to a tertiary cardiac care centre needed to be analysed.
Observational (n=511)
No
In COVID-19 patients with cardiovascular involvement, acute coronary syndrome is the most frequent manifestation and in-hospital mortality is high (18.9%), associated with elevated inflammatory and cardiac biomarkers.
Supports heightened ACS vigilance in COVID-19 with CVD; leaves open optimal management pending randomized evidence.
OBJECTIVES: To analyse the pattern of cardiovascular diseases (CVDs) in COVID-19 patients admitted to tertiary cardiac care centre. METHODS: We retrospectively analysed 511 adult patients admitted between July 1, 2020, and November 30, 2020, with COVID-19 infection and having either new onset or pre-existing CVDs. Clinical features, electrocardiogram (ECG), echocardiography, chest X-ray, biomarkers, haematological and biochemical parameters were analysed. RESULTS: The mean age of the patients was 56.62 ± 14.74 years. Male: Female ratio was 2.78:1. Pre-existing CVDs were present in 258 patients (50.5%). The most common cardiovascular manifestation was acute coronary syndrome (ACS), seen in 259 patients (50.7%). ST-segment elevation myocardial infarction (STEMI) was more common than non-ST-segment elevation ACS (NSTE-ACS). Possible myocarditis was seen in 52 patients (10.1%). Rhythm and conduction abnormalities were noted in 144 patients (28.2%), the most common being QT prolongation, seen in 51 patients (10%). In-hospital mortality occurred in 97 patients (18.9%). Age, serum Ferritin level, D-dimer, NT-pro-BNP and total leukocyte count were significantly higher among patients with in-hospital mortality compared to survival group. Blood lymphocyte count and Haemoglobin level were significantly lower in mortality-group, compared to survival-group. Incidence of pre-existing CVDs, cardiogenic shock, heart failure, atrial fibrillation (AF), and renal failure were significantly higher in mortality-group compared to survival-group. CONCLUSION: The most common CVD in COVID-19 patients in our study was ACS. STEMI was more common than NSTE-ACS. Advanced age, elevated serum ferritin, D-dimer, NT pro-BNP, leucocytosis, lymphopenia, lower haemoglobin, pre-existing CVDs heart failure, cardiogenic shock, AF and renal failure were associated with increased mortality in these patients.
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Puttegowda et al. (2021) conducted an observational in COVID-19 with cardiovascular diseases (n=511). COVID-19 with cardiovascular diseases was evaluated on Cardiovascular manifestations and in-hospital mortality. Among COVID-19 patients with cardiovascular diseases, acute coronary syndrome was the most common manifestation (50.7%), and in-hospital mortality occurred in 18.9% of patients.
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