Cardiovascular comorbidities – risk factors of death in COVID- 19 patients

Scope: The aim of the study was to assess the presence of cardiovascular comorbidities and the impact on mortality of patients with COVID-19.

Methods: The prospective study was performed on a group of 92 patients (mean age 61.51±3.42 years), wi-thout gender predominance (men 51.2% vs 48.8% wo-men) who met the definition of clinical and laboratory case, confirmed with COVID-19, hospitalized in Hos-pital no.1 and Saint Trinity. Patients were investigated clinically and paraclinically according to WHO Provi-sional Forms for reporting COVID-19 infection. The criteria for diagnosis and medical care were performed according to the Provisional National Clinical Protocol.

Results: Of the 92 cases with COVID-19, 54 (58.69%) reported at least one CVC. The prevalence of CVC forms was: chronic coronary syndromes (39.1%), hypertension (34.7%), diabetes (13.04%), malignancy (13.04%), cerebrovascular disease (8.6%), chronic ob-structive pulmonary disease (17.3%), chronic kidney disease (4.3%), viral hepatitis B (1.8%). Stratification of patients by severity revealed that 2 (4.74%) of 8 (8.69%) patients with mild severity COVID-19 with subfebrile fever without pneumonia and 11 (11.90%) of patients (58.42%, p <0.01) with COVID-19 of medium seve-rity, with fever and signs of non-severe pneumonia without hypoxemia (PaO2 94-95%) showed CVC.Hi-gher CVC coexistence compared with non-severe CO-VID-19 patients was estimated in 41 (75.92%, p<0.01) of the 55 (59.78%) patients with severe COVID-19 and the presence of pulmonary infiltrates radiologi-cally obvious bilateral, with fever, PaO2£93% at rest, PaO2/ FiO2≤300 mmHg, progressive decrease in the number of peripheral lymphocytes and rapid increase in serum lactate. The critical cases with death constitu-ted 7.61% and 66.67% of them described CVC, being older (average: 81.23 vs 57.33 years), they presented severe dyspnea, 3 of them with aggravated respirato-ry symptoms within one week after the onset of acute respiratory distress syndrome and rapid progression of lung imaging in the last 24-48 hours, with refractory hypoxemia, refractory metabolic acidosis, coagulation dysfunction and heart failure. Septic shock with persistent hypotension despite volume resuscitation, requiring vasopressors to maintain mean blood pressure ≥65 mmHg and serum lactate levels > 2 mmol/L were reported in 4 of the 7 patients treated with mechanical ventilation support.

Conclusions: T he presence of cardiovascular comorbidities and advanced age in patients with COVID-19 determine the severity of patients and increased mortality.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)