Background
Methods
Approvals
Study design
Data sources and processing
Exposures and outcomes
Statistical analyses
Results
Study population
Total N = 1721 | No CVD or CV risk factors N = 484 (28.1%) | RF-CVD N = 888 (51.6%) | CVD N = 349 (20.3%) | p value | |
---|---|---|---|---|---|
Demographics | |||||
Age, y | 71 (56–83) | 58 (44–75) | 71 (59–82) | 81 (71–88) | < 0.001 |
Age group, n (%) | < 0.001 | ||||
< 40 | 132 (7.7) | 97 (20.0) | 31 (3.5) | 4 (1.2) | |
40–49 | 127 (7.4) | 64 (13.2) | 55 (6.2) | 8 (2.3) | |
50–59 | 266 (15.5) | 93 (19.2) | 149 (16.8) | 24 (6.9) | |
60–69 | 303 (17.6) | 73 (15.1) | 187 (21.1) | 43 (12.3) | |
70–79 | 316 (18.4) | 56 (11.6) | 173 (19.5) | 87 (24.9) | |
80+ | 577 (33.5) | 101 (20.9) | 293 (33.0) | 183 (52.4) | |
Male sex | 974 (56.6) | 259 (53.5) | 522 (58.8) | 193 (55.3) | 0.146 |
BMI, kg/m2 | 26.2 (22.5–31.1) | 25.4 (21.8–30.6) | 26.9 (23.1–31.8) | 25.1 (22.0–29.0) | < 0.001 |
BMI category* | < 0.001 | ||||
Underweight | 74 (4.3) | 23 (4.8) | 29 (3.3) | 22 (6.3) | |
Normal weight | 349 (20.3) | 103 (21.3) | 152 (17.1) | 94 (26.9) | |
Overweight | 291 (16.9) | 71 (14.7) | 155 (17.5) | 65 (18.6) | |
Obese | 317 (18.4) | 83 (17.2) | 177 (19.9) | 57 (16.3) | |
Missing | 690 (40.1) | 204 (42.2) | 375 (42.2) | 111 (31.8) | |
Ethnicity | < 0.001 | ||||
White | 845 (49.1) | 238 (49.2) | 382 (43.0) | 225 (64.5) | |
Black | 434 (25.2) | 85 (17.6) | 280 (31.5) | 69 (19.8) | |
Asian | 96 (5.6) | 29 (6.0) | 55 (6.2) | 12 (3.4) | |
Mixed/other | 121 (7.0) | 37 (7.6) | 64 (7.2) | 20 (5.7) | |
Missing | 225 (13.1) | 95 (19.6) | 107 (12.1) | 23 (6.6) | |
Comorbidities | |||||
Cardiovascular risk factors | |||||
Hypertension | 963 (56.0) | – | 689 (77.6) | 274 (78.5) | 0.726 |
Diabetes | 601 (34.9) | – | 440 (49.6) | 161 (46.1) | 1.000 |
Type 1 | 6 (0.4) | – | 5 (0.6) | 1 (0.3) | 0.305 |
Type 2 | 595 (34.6) | – | 435 (49.0) | 160 (45.9) | 0.320 |
Ever smoker | 432 (25.1) | – | 314 (35.4) | 118 (33.8) | 0.607 |
Current smoker | 114 (6.6) | – | 85 (9.6) | 29 (8.3) | 0.490 |
Ex-smoker | 318 (18.5) | – | 229 (25.8) | 89 (25.5) | 0.917 |
Cardiovascular diseases | |||||
Previous myocardial infarction | 107 (6.2) | – | – | 107 (30.7) | – |
Chronic heart failure | 133 (7.7) | – | – | 133 (38.1) | – |
Previous myocarditis | 4 (0.2) | – | – | 4 (1.2) | – |
Previous pericarditis | 3 (0.2) | – | – | 3 (0.9) | – |
Arrhythmia | 218 (12.7) | – | – | 218 (62.5) | – |
Atrial fibrillation | 188 (10.9) | – | – | 188 (53.9) | – |
Valvular heart disease** | 15 (0.9) | – | – | 15 (4.3) | – |
Previous endocarditis | 16 (0.9) | – | – | 16 (4.6) | – |
Non-cardiac comorbidities | |||||
Asthma | 148 (8.6) | 16 (3.3) | 74 (8.3) | 58 (16.6) | < 0.001 |
COPD | 129 (7.5) | 5 (1.0) | 53 (6.0) | 71 (20.3) | < 0.001 |
Chronic kidney disease | 165 (9.6) | 6 (1.2) | 71 (8.0) | 88 (25.2) | < 0.001 |
Previous pulmonary embolism | 90 (5.2) | 8 (1.7) | 27 (3.0) | 55 (15.8) | < 0.001 |
Previous deep vein thrombosis | 110 (6.4) | 12 (2.5) | 37 (4.2) | 61 (17.5) | < 0.001 |
Medication | |||||
ACEI/ARB | 528 (31.4) | 29 (6.5) | 353 (39.9) | 146 (41.8) | < 0.001 |
Aldosterone antagonist | 66 (3.9) | 11 (2.5) | 24 (2.7) | 31 (8.9) | < 0.001 |
Beta-blocker | 430 (25.6) | 43 (9.6) | 197 (22.3) | 190 (54.4) | < 0.001 |
Calcium-channel blocker | 458 (27.3) | 26 (5.8) | 345 (39.0) | 87 (24.9) | < 0.001 |
Loop diuretic | 245 (14.6) | 20 (4.5) | 93 (10.5) | 132 (37.8) | < 0.001 |
Statin | 678 (40.3) | 64 (14.3) | 420 (47.5) | 194 (55.6) | < 0.001 |
Anticoagulant | 325 (19.3) | 53 (11.8) | 108 (12.2) | 164 (47.0) | < 0.001 |
Antiplatelet agent | 395 (23.5) | 47 (10.5) | 222 (25.1) | 126 (36.1) | < 0.001 |
Metformin | 299 (17.4) | – | 240 (27.0) | 59 (16.9) | – |
Sulphonylurea | 128 (7.4) | – | 104 (11.7) | 24 (6.9) | – |
Repaglinide | – | – | – | – | – |
SGLT2 inhibitor | 23 (1.3) | – | 17 (1.9) | 6 (1.7) | – |
DPP4 inhibitor | 134 (7.8) | – | 88 (9.9) | 46 (13.2) | – |
Thiazolidinedione | 4 (0.2) | – | 3 (0.3) | 1 (0.3) | – |
GLP1 receptor agonist | 14 (0.8) | – | 8 (0.9) | 6 (1.7) | – |
Insulin | 180 (10.5) | – | 128 (14.4) | 52 (14.9) | – |
COVID-19 investigational therapies | |||||
Hydroxychloroquine | 15 (0.9) | 6 (1.2) | 7 (0.8) | 2 (0.6) | 0.553 |
Dexamethasone/Prednisolone | 204 (11.9) | 50 (10.3) | 103 (11.6) | 51 (14.6) | 0.159 |
Remdesivir | 2 (0.1) | 1 (0.2) | – | 1 (0.3) | – |
Colchicine | 16 (0.9) | 2 (0.4) | 7 (0.8) | 7 (2.0) | 0.049 |
Tocilizumab | 2 (0.1) | – | – | 2 (0.6) | – |
Azithromycin | 26 (1.5) | 13 (2.7) | 8 (0.9) | 5 (1.4) | 0.035 |
Clinical presentation
In-hospital mortality
Total N = 1721 | No CVD or CV risk factors N = 484 (28.1%) | RF-CVD N = 888 (51.6%) | CVD N = 349 (20.3%) | p value | |
---|---|---|---|---|---|
Complications | |||||
Cardiac | |||||
Acute myocardial infarction | 68 (4.0) | 4 (0.8) | 21 (2.4) | 43 (12.3) | < 0.001 |
Acute heart failure | 151 (8.8) | 12 (2.5) | 43 (4.8) | 96 (27.5) | < 0.001 |
Myocarditis | 12 (0.7) | 0 | 9 (1.0) | 3 (0.9) | 0.090 |
Pericarditis | 2 (0.1) | 1 (0.2) | 1 (0.1) | 0 | 0.688 |
Arrhythmia* | 314 (18.3) | 40 (8.3) | 99 (11.2) | 175 (50.1) | < 0.001 |
Atrial fibrillation | 266 (15.5) | 28 (5.8) | 74 (8.3) | 164 (47.0) | < 0.001 |
Number of cardiac complications** | < 0.001 | ||||
0 | 1,290 (75.0) | 433 (89.5) | 738 (83.1) | 119 (34.1) | |
1 | 325 (18.9) | 45 (9.3) | 129 (14.5) | 151 (43.3) | |
2+ | 106 (6.2) | 6 (1.2) | 21 (2.4) | 79 (22.6) | |
Venous thromboembolism | |||||
Pulmonary embolism | 151 (8.8) | 41 (8.5) | 66 (7.4) | 44 (12.6) | 0.015 |
Deep vein thrombosis | 98 (5.7) | 21 (4.3) | 43 (4.8) | 34 (9.7) | 0.001 |
Extra-cardiac | |||||
Acute kidney injury*** ARDS Mechanical ventilation | 266 (15.5) 77 (4.5) 92 (34.9) | 30 (6.2) 19 (3.9) 36 (43.9) | 164 (18.5) 46 (5.2) 41 (27.2) | 72 (20.6) 12 (3.4) 15 (48.4) | < 0.001 0.324 0.009 |
Outcomes | |||||
Died in hospital | 438 (25.5) | 80 (16.5) | 228 (25.7) | 130 (37.3) | < 0.001 |
ICU admission | 226 (13.1) | 75 (15.3) | 127 (14.3) | 24 (6.9) | < 0.001 |
Death or ICU admission | 587 (34.1) | 133 (27.4) | 311 (35.0) | 145 (41.4) | < 0.001 |
Discharged from hospital alive | 1,246 (72.4) | 393 (81.2) | 639 (72.0) | 214 (61.3) | < 0.001 |
Hospital length of stay$, days | 9 (4–17) | 7 (3–16) | 8 (4–18) | 11 (5–19) | < 0.001 |