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. 2021 Oct:36:100853.
doi: 10.1016/j.ijcha.2021.100853. Epub 2021 Jul 30.

High risk coronavirus disease 2019: The primary results of the CoronaHeart multi-center cohort study

Patrícia O Guimarães  1   2 , Francis R de Souza  1 , Renato D Lopes  3 , Cristina Bittar  1 , Francisco A Cardozo  1 , Bruno Caramelli  1 , Daniela Calderaro  1 , Cícero P Albuquerque  1 , Luciano F Drager  1   4 , Fausto Feres  5 , Luciano Baracioli  1   4 , Gilson Feitosa Filho  6 , Roberto R Barbosa  7 , Henrique B Ribeiro  8 , Expedito Ribeiro  8 , Renato J Alves  9 , Alexandre Soeiro  10 , Bruno Faillace  11 , Estêvão Figueiredo  12 , Lucas P Damiani  1 , Renata M do Val  1 , Natassja Huemer  1 , Lisiê G Nicolai  1 , Ludhmila A Hajjar  1 , Alexandre Abizaid  1 , Roberto Kalil Filho  1   4
Affiliations

High risk coronavirus disease 2019: The primary results of the CoronaHeart multi-center cohort study

Patrícia O Guimarães et al. Int J Cardiol Heart Vasc. 2021 Oct.

Abstract

Background: Patients with Coronavirus Disease 2019 (COVID-19) may present high risk features during hospitalization, including cardiovascular manifestations. However, less is known about the factors that may further increase the risk of death in these patients.

Methods: We included patients with COVID-19 and high risk features according to clinical and/or laboratory criteria at 21 sites in Brazil from June 10th to October 23rd of 2020. All variables were collected until hospital discharge or in-hospital death.

Results: A total of 2546 participants were included (mean age 65 years; 60.3% male). Overall, 70.8% were admitted to intensive care units and 54.2% had elevated troponin levels. In-hospital mortality was 41.7%. An interaction among sex, age and mortality was found (p = 0.007). Younger women presented higher rates of death than men (30.0% vs 22.9%), while older men presented higher rates of death than women (57.6% vs 49.2%). The strongest factors associated with in-hospital mortality were need for mechanical ventilation (odds ratio [OR] 8.2, 95% confidence interval [CI] 5.4-12.7), elevated C-reactive protein (OR 2.3, 95% CI 1.7-2.9), cancer (OR 1.8, 95 %CI 1.2-2.9), and elevated troponin levels (OR 1.8, 95% CI 1.4-2.3). A risk score was developed for risk assessment of in-hospital mortality.

Conclusions: This cohort showed that patients with COVID-19 and high risk features have an elevated rate of in-hospital mortality with differences according to age and sex. These results highlight unique aspects of this population and might help identifying patients who may benefit from more careful initial surveillance and potential subsequent interventional therapies.

Keywords: COVID-19; High risk; In-hospital mortality.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
In-hospital mortality rates by age categories and sex.
Fig. 2
Fig. 2
In-hospital mortality rates by sex and age intervals.
Fig. 3
Fig. 3
The CoronaHeart Risk Score. CRP denotes C-reactive protein; ref., reference value.
See this image and copyright information in PMC

References

    1. Ck J., Fj A., Jayant R. COVID-19 and Cardiovascular Disease. Circulation. 2020;141(20):1648–1655. doi: 10.1161/CIRCULATIONAHA.120.046941. - DOI - PubMed
    1. Shi S, Qin M, Cai Y, et al. Characteristics and clinical significance of myocardial injury in patients with severe coronavirus disease 2019. Eur Heart J. Published online 2020. doi:10.1093/eurheartj/ehaa408 - PMC - PubMed
    1. Wei J.F., Huang F.Y., Xiong T.Y. Acute myocardial injury is common in patients with COVID-19 and impairs their prognosis. Heart. 2020 doi: 10.1136/heartjnl-2020-317007. - DOI - PMC - PubMed
    1. Bonow RO, Fonarow GC, O’Gara PT, Yancy CW. Association of Coronavirus Disease 2019 (COVID-19) with Myocardial Injury and Mortality. JAMA Cardiol. Published online 2020. doi:10.1001/jamacardio.2020.1105 - PubMed
    1. Yang J, Zheng Y, Gou X, et al. Prevalence of comorbidities and its effects in coronavirus disease 2019 patients: A systematic review and meta-analysis. Int J Infect Dis. Published online 2020. doi:10.1016/j.ijid.2020.03.017 - PMC - PubMed