Cardiac comorbidities impact on the outcomes in severe COVID-19 infection

Abstract

Background: COVID-19 is now a global pandemic, with the officially recorded number of affected individuals approaching 4 billion patients. Aim of the Work: Our purpose is to study the effect of cardiac comorbidities on the outcomes of severely infected COVID-19 patients. Patients and Methods: This study included 147 patients with severe COVID-19. All data were analyzed regarding demographic risk factors, associated diseases, mode of oxygen therapy administration, and echocardiography. Results: The death rate (DR) in patients with severe COVID-19 and no comorbidities was 7.7%. In patients who had only one risk factor as smoking, hypertension (HTN), or diabetes mellitus (DM), the DR was 16.7%, 33.3%, and 8.3%, respectively. The addition of one risk factor to HTN increased DR in the case of DM (36.8%) and in the case of smoking (40%). Regarding the outcomes, the percentage of the patients affected was as follows: impaired left ventricular ejection fraction (LVEF) 30 mmHg (53.7%), and pericardial effusion (23.1%). Patients were subclassified according to the presence of HTN. The hypertensive group had increased LV wall thickness and LV end-systolic dimension and impaired LVEF and fraction of shortening than normotensive patients. DR for females and males treated by high-flow nasal cannula was (3.3% vs. 6.9%), continuous positive airway pressure (0% vs. 3.2%), and mechanical ventilation (100% vs. 90.5%). The suggested score was significantly higher in the death group (P < 00001). The DR increased markedly with the incremental rising score. Conclusions: Comorbidities, age, and delayed presentation with decreased oxygen saturation had a cumulative risk that can predict the outcome of COVID-19 patients. The presence of HTN alone or associated with other risk factors had a higher DR than other risk factors.

Keywords

• comorbidity score
• covid-19
• echocardiography
• hypertension
• oxygen saturation
• ventricular function