期刊
GLOBAL HEART
卷 17, 期 1, 页码 -出版社
UBIQUITY PRESS LTD
DOI: 10.5334/gh.1128
关键词
COVID-19; mortality; cardiovascular disease
资金
- National Institutes of Health, Fogarty International Centre, USA
- Emerging Global Leader grant [1 K43 TW011164]
- CNPq [310679/2016-8, 465518/2014-1]
- FAPEMIG [PPM-00428-17]
- CAPES [88887.507149/2020-00]
- Hippocrate Foundation
- European and Developing Countries Clinical Trials Partnership (EDCTP) of the European Union
This study aimed to describe the cardiovascular risk factors, clinical manifestations, and outcomes of COVID-19 patients hospitalized in different income countries. The study found that older age, male sex, pre-existing coronary heart disease, renal disease, diabetes, ICU admission, oxygen therapy, and higher respiratory rates were predictors of increased mortality. Asians, Blacks, and Hispanics had a higher risk of death compared to Caucasians. Patients from low, lower-middle, and upper-middle-income countries had a higher risk of death.
Background and aims: Limited data exist on the cardiovascular manifestations and risk factors in people hospitalized with COVID-19 from low-and middle-income countries. This study aims to describe cardiovascular risk factors, clinical manifestations, and outcomes among patients hospitalized with COVID-19 in low, lower-middle, upper middle-and high-income countries (LIC, LMIC, UMIC, HIC). Methods: Through a prospective cohort study, data on demographics and pre-existing conditions at hospital admission, clinical outcomes at hospital discharge (death, major adverse cardiovascular events (MACE), renal failure, neurological events, and pulmonary outcomes), 30-day vital status, and re-hospitalization were collected. Descriptive analyses and multivariable log-binomial regression models, adjusted for age, sex, ethnicity/income groups, and clinical characteristics, were performed. Results: Forty hospitals from 23 countries recruited 5,313 patients with COVID-19 (LIC = 7.1%, LMIC = 47.5%, UMIC = 19.6%, HIC = 25.7%). Mean age was 57.0 (+/- 16.1) years, male 59.4%, pre-existing conditions included: hypertension 47.3%, diabetes 32.0%, coronary heart disease 10.9%, and heart failure 5.5%. The most frequently reported cardiovascular discharge diagnoses were cardiac arrest (5.5%), acute heart failure (3.8%), and myocardial infarction (1.6%). The rate of in-hospital deaths was 12.9% (N = 683), and post-discharge 30 days deaths was 2.6% (N = 118) (overall death rate 15.1%). The most common causes of death were respiratory failure (39.3%) and sudden cardiac death (20.0%). The predictors of overall mortality included older age (>= 60 years), male sex, pre-existing coronary heart disease, renal disease, diabetes, ICU admission, oxygen therapy, and higher respiratory rates (p < 0.001 for each). Compared to Caucasians, Asians, Blacks, and Hispanics had almost 2-4 times higher risk of death. Further, patients from LIC, LMIC, UMIC versus. HIC had 2-3 times increased risk of death. Conclusions: The LIC, LMIC, and UMIC's have sparse data on COVID-19. We provide robust evidence on COVID-19 outcomes in these countries. This study can help guide future health care planning for the pandemic globally.
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