Fatal COVID-19 outcomes associated with CVD, risk factors regardless of age
Fatal outcomes in COVID-19 were associated with patients with CVD and risk factors such as hypertension and diabetes across all age groups, according to a meta-analysis.
“The presence of underlying CVD increases both the severity of the primary respiratory disease and the risk of developing further complications,” Sunga Bae, MD, from the division of cardiology at Korea University Anam Hospital in Seoul, South Korea, and colleagues wrote. “It has been reported that the major risk factors for mortality in patients with COVID-19 include age greater than 60 years, male sex and the presence of comorbidities.”
For the meta-analysis, researchers evaluated 51 studies involving 48,317 patients (median age, 56 years; 58% men) with COVID-19 through June. The included studies assessed in-hospital patients. Researchers stratified prevalence rates of comorbid diseases and clinical outcomes by mean patient age.
The primary outcome was a composite fatal outcome of severe COVID-19 or death.
Researchers observed a significantly higher relative risk for developing severe COVID-19 infection or death in patients with risk factors for CVD like hypertension (OR = 2.5; 95% CI, 2.15-2.9) or diabetes (OR = 2.25; 95% CI, 1.89-2.69) as well as in patients with CVD (OR = 3.11; 95% CI, 2.55-3.79). Younger patients (less than 50 years) demonstrated a lower prevalence of hypertension, diabetes and CVD compared with older patients (60 years or older), but the relative risk for fatal outcomes among younger patients was higher.
According to the researchers, the exact reason as to why younger patients with CVD or risk factors for CVD were at a higher risk for poor clinical outcomes compared with older patients remains unknown.
“Although young patients had a lower prevalence of cardiovascular comorbidities compared with elderly patients, their relative risk of developing fatal outcomes was higher than that of elderly patients,” the researchers wrote. “Among the patients with COVID-19, we need to pay special attention to young patients with cardiovascular morbidities as well as the elderly.”