Cardiovascular Risk Factors and Clinical Outcomes among Patients Hospitalized with COVID-19: Findings from the World Heart Federation COVID-19 Study.
Cardiovascular Risk Factors and Clinical Outcomes among Patients Hospitalized with COVID-19: Findings from the World Heart Federation COVID-19 Study.
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DOI：
10.5334/gh.1128
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Sliwa, Karen
中科院分区：
文献类型：
--
作者：
Prabhakaran, Dorairaj;Singh, Kavita;Kondal, Dimple;Raspail, Lana;Mohan, Bishav;Kato, Toru;Sarrafzadegan, Nizal;Talukder, Shamim hayder;Akter, Shahin;Amin, Mohammad Robed;Goma, Fastone;Gomez-Mesa, Juan;Ntusi, Ntobeko;Inofomoh, Francisca;Deora, Surender;Philippov, Evgenii;Svarovskaya, Alla;Konradi, Alexandra;Puentes, Aurelio;Ogah, Okechukwu S.;Stanetic, Bojan;Issa, Aurora;Thienemann, Friedrich;Juzar, Dafsah;Zaidel, Ezequiel;Sheikh, Sana;Ojji, Dike;Lam, Carolyn S. P.;Ge, Junbo;Banerjee, Amitava;Newby, L. Kristin;Ribeiro, Antonio Luiz P.;Gidding, Samuel;Pinto, Fausto;Perel, Pablo;Sliwa, Karen
关于低收入和中等收入国家COVID-19住院患者的心血管表现和风险因素的数据有限。本研究旨在描述低收入、中低收入、中高收入和高收入国家（LIC、LMIC、UMIC、HIC）COVID-19住院患者的心血管风险因素、临床表现和结局。通过一项前瞻性队列研究，收集了入院时的人口统计学和既存疾病、出院时的临床结局（死亡、主要不良心血管事件（MACE）、肾衰竭、神经系统事件和肺部结局）、30天生命状态和再次住院的数据。进行了描述性分析和多变量对数二项回归模型，调整了年龄、性别、种族/收入组和临床特征。来自23个国家的40家医院招募了5，313名COVID-19患者（LIC = 7.1%，LMIC = 47.5%，UMIC = 19.6%，HIC = 25.7%）。平均年龄为57.0（±16.1）岁，男性59.4%，既往疾病包括：高血压47.3%、糖尿病32.0%、冠心病10.9%和心力衰竭5.5%。最常报告的心血管出院诊断为心脏骤停（5.5%）、急性心力衰竭（3.8%）和心肌梗死（1.6%）。院内死亡率为12.9%（N = 683），出院后30天死亡率为2.6%（N = 118）（总死亡率为15.1%）。最常见的死亡原因是呼吸衰竭（39.3%）和心源性猝死（20.0%）。总死亡率的预测因素包括高龄（≥60岁）、男性、既往冠心病、肾脏疾病、糖尿病、ICU入院、氧疗和呼吸频率升高（各P < 0.001）。与白人相比，亚洲人，黑人和西班牙裔人的死亡风险几乎高出2-4倍。此外，来自LIC、LMIC、UMIC的患者与. HIC的死亡风险增加2-3倍。LIC、LMIC和UMIC关于COVID-19的数据很少。我们提供了有关这些国家COVID-19结果的有力证据。这项研究可以帮助指导未来全球大流行的卫生保健规划。
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). 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. 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. 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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