Open Heart (Feb 2021)

COVID-19 and its impact on the cardiovascular system

  • Farhan Huq,
  • Ricardo Petraco,
  • Sayan Sen,
  • Rasha Al-Lamee,
  • Sukhjinder Nijjer,
  • Punam Pabari,
  • Ramzi Khamis,
  • Richard Jabbour,
  • Prapa Kanagaratnam,
  • Gemma Bowsher,
  • Neil Ruparelia,
  • Iqbal Malik,
  • Kevin Fox,
  • Amarjit Sethi,
  • Brian Wang,
  • Gajen Kanaganayagam,
  • Petros Nihoyannopoulos,
  • Rachel Davies,
  • Christopher S R Baker,
  • Saud Ahmed Khawaja,
  • Poornima Mohan,
  • Theodora Bampouri,
  • Ahmed M M Hassan,
  • Lilit Baghdasaryan,
  • Rodney Foale,
  • Michael Bellamy,
  • Jaspal Kooner,
  • Bushra Rana,
  • Graham Cole,
  • Nilesh Sutaria,
  • Carla Plymen,
  • Luke Howard,
  • Gulammehdi Haji,
  • Francesco Lo Giudice,
  • Jon Anderson,
  • Andrew Chukwuemeka,
  • Amanda Varnava,
  • Darrel Parthipan Francis,
  • Perviz Asaria,
  • Ghada W Mikhail

DOI
https://doi.org/10.1136/openhrt-2020-001472
Journal volume & issue
Vol. 8, no. 1

Abstract

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Objectives The clinical impact of SARS-CoV-2 has varied across countries with varying cardiovascular manifestations. We review the cardiac presentations, in-hospital outcomes and development of cardiovascular complications in the initial cohort of SARS-CoV-2 positive patients at Imperial College Healthcare National Health Service Trust, UK.Methods We retrospectively analysed 498 COVID-19 positive adult admissions to our institute from 7 March to 7 April 2020. Patient data were collected for baseline demographics, comorbidities and in-hospital outcomes, especially relating to cardiovascular intervention.Results Mean age was 67.4±16.1 years and 62.2% (n=310) were male. 64.1% (n=319) of our cohort had underlying cardiovascular disease (CVD) with 53.4% (n=266) having hypertension. 43.2%(n=215) developed acute myocardial injury. Mortality was significantly increased in those patients with myocardial injury (47.4% vs 18.4%, p<0.001). Only four COVID-19 patients had invasive coronary angiography, two underwent percutaneous coronary intervention and one required a permanent pacemaker implantation. 7.0% (n=35) of patients had an inpatient echocardiogram. Acute myocardial injury (OR 2.39, 95% CI 1.31 to 4.40, p=0.005) and history of hypertension (OR 1.88, 95% CI 1.01 to 3.55, p=0.049) approximately doubled the odds of in-hospital mortality in patients admitted with COVID-19 after other variables had been controlled for.Conclusion Hypertension, pre-existing CVD and acute myocardial injury were associated with increased in-hospital mortality in our cohort of COVID-19 patients. However, only a low number of patients required invasive cardiac intervention.