Smoking, diabetes and obesity – not preexisting heart disease – bigger risk of COVID-19 death
A national study suggests that risk factors for cardiovascular disease, such as age, smoking and diabetes – not pre-existing heart disease – are the main contributors to death and poor outcomes for critically ill COVID-19 patients.
A team led by Michigan Medicine researchers analyzed outcomes for more than 5,100 patients admitted to intensive care units at 68 centers across the United States with severe COVID between March and June of 2020. Of those patients, 1,174 had either preexisting coronary artery disease, congestive heart failure or atrial fibrillation.
Results reveal that patients with cardiovascular disease had close to a 30% higher mortality rate than critically ill COVID patients without the preexisting condition. However, when adjusting for risk factors – including age, sex, race, smoking and others – that relationship was no longer statistically significant. The findings are published in Circulation: Cardiovascular Quality and Outcomes.
A total of 34.6% of patients died within 28 days and nearly 18% suffered a cardiovascular event, such as cardiac arrest or myocarditis. Researchers say the association between such events and death did not differ between patients with and without preexisting heart disease.
Cardiovascular disease is a common condition among patients who suffer severe COVID illness, given its prevalence among older adults and associated chronic inflammation. In the study, age, obesity and diabetes were much stronger predictors of death due to COVID.
Regardless of whether a patient had pre-existing heart disease, researchers found the presence of myocardial injury was associated with cardiovascular events and death. Myocardial injury was common among patients in the ICU, occurring in nearly half of patients who had heightened levels of troponin, a protein released when the heart muscle is damaged. Patients with the highest troponin measurements were nearly three times more likely to die than those without myocardial injury.
