Pre-existing cardiovascular disease, acute kidney injury, and cardiovascular outcomes in hospitalized blacks with COVID-19 infection.

COVID-19 Pre-existing CVD acute kidney injury blacks mortality

Journal

American journal of cardiovascular disease
ISSN: 2160-200X
Titre abrégé: Am J Cardiovasc Dis
Pays: United States
ID NLM: 101569582

Informations de publication

Date de publication:
2021
Historique:
received: 22 12 2020
accepted: 15 03 2021
entrez: 4 6 2021
pubmed: 5 6 2021
medline: 5 6 2021
Statut: epublish

Résumé

The Corona Virus 19 (COVID-19) infection is associated with worse outcomes in blacks, although the mechanisms are unclear. We sought to determine the significance of black race, pre-existing cardiovascular disease (pCVD), and acute kidney injury (AKI) on cardiopulmonary outcomes and in-hospital mortality of COVID-19 patients. We conducted a retrospective cohort study of blacks with/without pCVD and with/without in-hospital AKI, hospitalized within Grady Memorial Hospital in Georgia between February and July 2020, who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on qualitative polymerase-chain-reaction assay. The primary outcome was a composite of in-hospital cardiac events. Of the 293 patients hospitalized with COVID-19 in this study, 71 were excluded from the primary analysis (for race/ethnicity other than black non-Hispanic). Of the 222 hospitalized COVID-19 patients included in our analyses, 41.4% were female, 78.8% had pCVD, and 30.6% developed AKI during the admission. In multivariable analyses, pCVD (OR 4.7, 95% CI 1.5-14.8, P=0.008) and AKI (OR 2.7, 95% CI 1.3-5.5, P=0.006) were associated with increased odds of in-hospital cardiac events. AKI was associated with increased odds of in-hospital mortality (OR 8.9, 95% CI 3.3-23.9, P<0.0001). The presence of AKI was associated with increased odds of ICU stay, mechanical ventilation, and acute respiratory distress syndrome (ARDS). pCVD and AKI were associated with higher risk of in-hospital cardiac events, and AKI was associated with a higher risk of in-hospital mortality in blacks.

Sections du résumé

BACKGROUND BACKGROUND
The Corona Virus 19 (COVID-19) infection is associated with worse outcomes in blacks, although the mechanisms are unclear. We sought to determine the significance of black race, pre-existing cardiovascular disease (pCVD), and acute kidney injury (AKI) on cardiopulmonary outcomes and in-hospital mortality of COVID-19 patients.
METHODS METHODS
We conducted a retrospective cohort study of blacks with/without pCVD and with/without in-hospital AKI, hospitalized within Grady Memorial Hospital in Georgia between February and July 2020, who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on qualitative polymerase-chain-reaction assay. The primary outcome was a composite of in-hospital cardiac events.
RESULTS RESULTS
Of the 293 patients hospitalized with COVID-19 in this study, 71 were excluded from the primary analysis (for race/ethnicity other than black non-Hispanic). Of the 222 hospitalized COVID-19 patients included in our analyses, 41.4% were female, 78.8% had pCVD, and 30.6% developed AKI during the admission. In multivariable analyses, pCVD (OR 4.7, 95% CI 1.5-14.8, P=0.008) and AKI (OR 2.7, 95% CI 1.3-5.5, P=0.006) were associated with increased odds of in-hospital cardiac events. AKI was associated with increased odds of in-hospital mortality (OR 8.9, 95% CI 3.3-23.9, P<0.0001). The presence of AKI was associated with increased odds of ICU stay, mechanical ventilation, and acute respiratory distress syndrome (ARDS).
CONCLUSION CONCLUSIONS
pCVD and AKI were associated with higher risk of in-hospital cardiac events, and AKI was associated with a higher risk of in-hospital mortality in blacks.

Identifiants

pubmed: 34084656
pmc: PMC8166582

Types de publication

Journal Article

Langues

eng

Pagination

212-221

Informations de copyright

AJCD Copyright © 2021.

Déclaration de conflit d'intérêts

None.

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Auteurs

Obiora Egbuche (O)

Division of Cardiovascular Disease, Morehouse School of Medicine Atlanta, GA 30310, USA.

Opeyemi Jegede (O)

Department of Biostatistics and Epidemiology, University of North Texas Health Science Center Fort-Worth, TX 76107, USA.

Temidayo Abe (T)

Department of Internal Medicine, Morehouse School of Medicine Atlanta, GA 30310, USA.

Bivek Wagle (B)

Department of Internal Medicine, Morehouse School of Medicine Atlanta, GA 30310, USA.

Ky Huynh (K)

Department of Internal Medicine, Morehouse School of Medicine Atlanta, GA 30310, USA.

Dolphurs Hayes (D)

Department of Internal Medicine, Morehouse School of Medicine Atlanta, GA 30310, USA.

Martin Luther Campbell (ML)

Department of Internal Medicine, Morehouse School of Medicine Atlanta, GA 30310, USA.

Kenechukwu Mezue (K)

Division of Nuclear Cardiology, Massachusetts General Hospital, Harvard Medical School Boston, MA 02114, USA.

Pradhum Ram (P)

Division of Cardiovascular Disease, Emory University School of Medicine Atlanta, GA 30322, USA.

Shirley I Nwokike (SI)

Department of Internal Medicine, Medical College of Georgia Augusta, GA 30912, USA.

Rupak Desai (R)

Division of Cardiovascular Disease, Atlanta VA Medical Center Decatur, GA 30033, USA.

Valery Effoe (V)

Division of Cardiovascular Disease, Morehouse School of Medicine Atlanta, GA 30310, USA.

Jacques Kpodonu (J)

Division of Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA 02215, USA.

Jayne Morgan (J)

Division of Quality and Safety, Piedmont Healthcare, Inc. Atlanta, GA 30309, USA.

Elizabeth Ofili (E)

Division of Cardiovascular Disease, Morehouse School of Medicine Atlanta, GA 30310, USA.

Anekwe Onwuanyi (A)

Division of Cardiovascular Disease, Morehouse School of Medicine Atlanta, GA 30310, USA.

Melvin R Echols (MR)

Division of Cardiovascular Disease, Morehouse School of Medicine Atlanta, GA 30310, USA.

Classifications MeSH