COVID-19 and its impact on the cardiovascular system

oleh: Farhan Huq, Ricardo Petraco, Sayan Sen, Rasha Al-Lamee, Sukhjinder Nijjer, Punam Pabari, Ramzi Khamis, Richard Jabbour, Prapa Kanagaratnam, Gemma Bowsher, Neil Ruparelia, Iqbal Malik, Kevin Fox, Amarjit Sethi, Brian Wang, Gajen Kanaganayagam, Petros Nihoyannopoulos, Rachel Davies, Christopher S R Baker, Saud Ahmed Khawaja, Poornima Mohan, Theodora Bampouri, Ahmed M M Hassan, Lilit Baghdasaryan, Rodney Foale, Michael Bellamy, Jaspal Kooner, Bushra Rana, Graham Cole, Nilesh Sutaria, Carla Plymen, Luke Howard, Gulammehdi Haji, Francesco Lo Giudice, Jon Anderson, Andrew Chukwuemeka, Amanda Varnava, Darrel Parthipan Francis, Perviz Asaria, Ghada W Mikhail

Format: Article
Diterbitkan: BMJ Publishing Group 2021-06-01

Deskripsi

Objectives The clinical impact of SARS-CoV-2 has varied across countries with varying cardiovascular manifestations. We review the cardiac presentations, in-hospital outcomes and development of cardiovascular complications in the initial cohort of SARS-CoV-2 positive patients at Imperial College Healthcare National Health Service Trust, UK.Methods We retrospectively analysed 498 COVID-19 positive adult admissions to our institute from 7 March to 7 April 2020. Patient data were collected for baseline demographics, comorbidities and in-hospital outcomes, especially relating to cardiovascular intervention.Results Mean age was 67.4±16.1 years and 62.2% (n=310) were male. 64.1% (n=319) of our cohort had underlying cardiovascular disease (CVD) with 53.4% (n=266) having hypertension. 43.2%(n=215) developed acute myocardial injury. Mortality was significantly increased in those patients with myocardial injury (47.4% vs 18.4%, p<0.001). Only four COVID-19 patients had invasive coronary angiography, two underwent percutaneous coronary intervention and one required a permanent pacemaker implantation. 7.0% (n=35) of patients had an inpatient echocardiogram. Acute myocardial injury (OR 2.39, 95% CI 1.31 to 4.40, p=0.005) and history of hypertension (OR 1.88, 95% CI 1.01 to 3.55, p=0.049) approximately doubled the odds of in-hospital mortality in patients admitted with COVID-19 after other variables had been controlled for.Conclusion Hypertension, pre-existing CVD and acute myocardial injury were associated with increased in-hospital mortality in our cohort of COVID-19 patients. However, only a low number of patients required invasive cardiac intervention.