Even with numerous vaccines now being distributed, the COVID-19 pandemic continues to cause havoc for health systems all over the world. Numerous studies have confirmed that patients with cardiovascular disease face an especially high risk of serious COVID-related illness or even death, but when might a patient have a greater chance of experiencing a major adverse cardiovascular event (MACE)?
A research team out of the Yale University School of Medicine aimed to find out, sharing its analysis in the American Journal of Cardiology.
The study’s authors examined data from 586 consecutive hospitalized COVID-19 patients. All patients were treated at the same tertiary care medical center in Connecticut from March 1 to May 31, 2020.
“Our study is particularly notable for its data acquisition through manual chart review and event adjudication by experienced physicians, approaches that provide more reliable information than use of administrative registries alone,” wrote first author Manan Pareek, MD, PhD, department of internal medicine at Yale New Haven Hospital and Yale University School of Medicine, and colleagues.
The cohort had a median age of 67 years old, 52.6% were male and 36.7% had established cardiovascular disease. The most common presenting symptoms were cough (59.6%) and fever or chills (58.7%). Also, 14% of patients died in the hospital and 23% experienced a MACE. The most commonly reported MACE was new atrial fibrillation or flutter (7.9%), followed by a type 2 myocardial infarction (7.5%).
Overall, after adjustments were made based on demographics and other key variables, the team found that these seven risk factors were associated with a higher chance of death or a MACE among hospitalized COVID-19 patients:
- Pre-existing cardiovascular disease
- Older age
- Male sex
- An early need for oxygen supplementation
- Higher respiratory rates
- Altered mental status
- Abnormal lab results, including higher troponin T concentrations
The authors also used this analysis to examine if certain medications—mainly RAAS inhibitors and non-steroidal anti-inflammatory drugs (NSAIDs)—could have a negative impact on COVID-19 patients.
“Importantly, we found no detrimental effects of RAAS inhibitors or NSAIDs,” the authors wrote. “Both received considerable attention early during the pandemic because of their potential ability to upregulate expression of ACE-2, the molecule used by SARS-CoV2 for endocytic internalization. Our results are in agreement with other observational studies of these drug classes.”
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Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.