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Norris T, Razieh C, Zaccardi F, Yates T, Islam N, Gillies CL, Chudasama YV, Rowlands AV, Davies MJ, McCann GP, Banerjee A, Lam CSP, Docherty AB, Openshaw PJ, Baillie JK, Semple MG, Lawson CA, Khunti K. Impact of cardiometabolic multimorbidity and ethnicity on cardiovascular/renal complications in patients with COVID-19. Heart 2022; 108:1200-1208. [PMID: 34911741 PMCID: PMC8678560 DOI: 10.1136/heartjnl-2021-320047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/08/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Using a large national database of people hospitalised with COVID-19, we investigated the contribution of cardio-metabolic conditions, multi-morbidity and ethnicity on the risk of in-hospital cardiovascular complications and death. METHODS A multicentre, prospective cohort study in 302 UK healthcare facilities of adults hospitalised with COVID-19 between 6 February 2020 and 16 March 2021. Logistic models were used to explore associations between baseline patient ethnicity, cardiometabolic conditions and multimorbidity (0, 1, 2, >2 conditions), and in-hospital cardiovascular complications (heart failure, arrhythmia, cardiac ischaemia, cardiac arrest, coagulation complications, stroke), renal injury and death. RESULTS Of 65 624 patients hospitalised with COVID-19, 44 598 (68.0%) reported at least one cardiometabolic condition on admission. Cardiovascular/renal complications or death occurred in 24 609 (38.0%) patients. Baseline cardiometabolic conditions were independently associated with increased odds of in-hospital complications and this risk increased in the presence of cardiometabolic multimorbidity. For example, compared with having no cardiometabolic conditions, 1, 2 or ≥3 conditions was associated with 1.46 (95% CI 1.39 to 1.54), 2.04 (95% CI 1.93 to 2.15) and 3.10 (95% CI 2.92 to 3.29) times higher odds of any cardiovascular/renal complication, respectively. A similar pattern was observed for all-cause death. Compared with the white group, the South Asian (OR 1.19, 95% CI 1.10 to 1.29) and black (OR 1.53 to 95% CI 1.37 to 1.72) ethnic groups had higher risk of any cardiovascular/renal complication. CONCLUSIONS In hospitalised patients with COVID-19, cardiovascular complications or death impacts just under half of all patients, with the highest risk in those of South Asian or Black ethnicity and in patients with cardiometabolic multimorbidity.
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Affiliation(s)
- Tom Norris
- Leicester Real World Evidence Unit, Leicester General Hospital, Leicester, UK
| | - Cameron Razieh
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
| | - Francesco Zaccardi
- Leicester Real World Evidence Unit, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
| | - Nazrul Islam
- Big Data Institute, University of Oxford, Oxford, Oxfordshire, UK
| | - Clare L Gillies
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
| | - Yogini V Chudasama
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
| | - Alex V Rowlands
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
| | - Gerry P McCann
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Amitava Banerjee
- Farr Institute of Health Informatics Research, University College London, London, UK
| | - Carolyn S P Lam
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | - Annemarie B Docherty
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, Edinburgh, UK
| | | | - J Kenneth Baillie
- The Roslin Institute, The University of Edinburgh, Easter Bush Campus, Midlothian, UK
| | | | - Claire Alexandra Lawson
- Leicester Real World Evidence Unit, Leicester General Hospital, Leicester, UK
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Kamlesh Khunti
- Leicester Real World Evidence Unit, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK
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