Impact of cardiometabolic multimorbidity and ethnicity on cardiovascular/renal complications in patients with COVID-19
Impact of cardiometabolic multimorbidity and ethnicity on cardiovascular/renal complications in patients with COVID-19
Objective: using a large national database of people hospitalised with COVID-19, we investigated the contribution of cardio-metabolic conditions, multi-morbidity and ethnicity on the risk of in-hospital cardiovascular complications and death.
Methods: a multicentre, prospective cohort study in 302 UK healthcare facilities of adults hospitalised with COVID-19 between 6 February 2020 and 16 March 2021. Logistic models were used to explore associations between baseline patient ethnicity, cardiometabolic conditions and multimorbidity (0, 1, 2, >2 conditions), and in-hospital cardiovascular complications (heart failure, arrhythmia, cardiac ischaemia, cardiac arrest, coagulation complications, stroke), renal injury and death.
Results: of 65 624 patients hospitalised with COVID-19, 44 598 (68.0%) reported at least one cardiometabolic condition on admission. Cardiovascular/renal complications or death occurred in 24 609 (38.0%) patients. Baseline cardiometabolic conditions were independently associated with increased odds of in-hospital complications and this risk increased in the presence of cardiometabolic multimorbidity. For example, compared with having no cardiometabolic conditions, 1, 2 or ≥3 conditions was associated with 1.46 (95% CI 1.39 to 1.54), 2.04 (95% CI 1.93 to 2.15) and 3.10 (95% CI 2.92 to 3.29) times higher odds of any cardiovascular/renal complication, respectively. A similar pattern was observed for all-cause death. Compared with the white group, the South Asian (OR 1.19, 95% CI 1.10 to 1.29) and black (OR 1.53 to 95% CI 1.37 to 1.72) ethnic groups had higher risk of any cardiovascular/renal complication.
Conclusions: in hospitalised patients with COVID-19, cardiovascular complications or death impacts just under half of all patients, with the highest risk in those of South Asian or Black ethnicity and in patients with cardiometabolic multimorbidity.
Adult, COVID-19/complications, Ethnicity, Humans, Kidney, Multimorbidity, Prospective Studies, Risk Factors
1200-1208
Norris, Tom
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Razieh, Cameron
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Zaccardi, Francesco
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Yates, Thomas
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Islam, Nazrul
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Gillies, Clare L.
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Chudasama, Yogini V.
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Rowlands, Alex V.
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Davies, Melanie J.
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McCann, Gerry P
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Banerjee, Amitava
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Lam, Carolyn S.P.
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Docherty, Annemarie B.
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Openshaw, Peter J.M.
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Baillie, J. Kenneth
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Semple, Malcolm Gracie
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Lawson, Claire Alexandra
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Khunti, Kamlesh
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Dushianthan, Ahilanandan
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13 July 2022
Norris, Tom
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Razieh, Cameron
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Zaccardi, Francesco
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Yates, Thomas
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Islam, Nazrul
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Gillies, Clare L.
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Chudasama, Yogini V.
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Rowlands, Alex V.
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Davies, Melanie J.
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McCann, Gerry P
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Banerjee, Amitava
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Lam, Carolyn S.P.
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Docherty, Annemarie B.
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Openshaw, Peter J.M.
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Baillie, J. Kenneth
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Semple, Malcolm Gracie
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Lawson, Claire Alexandra
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Khunti, Kamlesh
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Dushianthan, Ahilanandan
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Norris, Tom, Razieh, Cameron, Zaccardi, Francesco, Yates, Thomas, Islam, Nazrul, Gillies, Clare L., Chudasama, Yogini V., Rowlands, Alex V., Davies, Melanie J., McCann, Gerry P, Banerjee, Amitava, Lam, Carolyn S.P., Docherty, Annemarie B., Openshaw, Peter J.M., Baillie, J. Kenneth, Semple, Malcolm Gracie, Lawson, Claire Alexandra and Khunti, Kamlesh
,
ISARIC4C Investigators
(2022)
Impact of cardiometabolic multimorbidity and ethnicity on cardiovascular/renal complications in patients with COVID-19.
Heart, 108 (15), .
(doi:10.1136/heartjnl-2021-320047).
Abstract
Objective: using a large national database of people hospitalised with COVID-19, we investigated the contribution of cardio-metabolic conditions, multi-morbidity and ethnicity on the risk of in-hospital cardiovascular complications and death.
Methods: a multicentre, prospective cohort study in 302 UK healthcare facilities of adults hospitalised with COVID-19 between 6 February 2020 and 16 March 2021. Logistic models were used to explore associations between baseline patient ethnicity, cardiometabolic conditions and multimorbidity (0, 1, 2, >2 conditions), and in-hospital cardiovascular complications (heart failure, arrhythmia, cardiac ischaemia, cardiac arrest, coagulation complications, stroke), renal injury and death.
Results: of 65 624 patients hospitalised with COVID-19, 44 598 (68.0%) reported at least one cardiometabolic condition on admission. Cardiovascular/renal complications or death occurred in 24 609 (38.0%) patients. Baseline cardiometabolic conditions were independently associated with increased odds of in-hospital complications and this risk increased in the presence of cardiometabolic multimorbidity. For example, compared with having no cardiometabolic conditions, 1, 2 or ≥3 conditions was associated with 1.46 (95% CI 1.39 to 1.54), 2.04 (95% CI 1.93 to 2.15) and 3.10 (95% CI 2.92 to 3.29) times higher odds of any cardiovascular/renal complication, respectively. A similar pattern was observed for all-cause death. Compared with the white group, the South Asian (OR 1.19, 95% CI 1.10 to 1.29) and black (OR 1.53 to 95% CI 1.37 to 1.72) ethnic groups had higher risk of any cardiovascular/renal complication.
Conclusions: in hospitalised patients with COVID-19, cardiovascular complications or death impacts just under half of all patients, with the highest risk in those of South Asian or Black ethnicity and in patients with cardiometabolic multimorbidity.
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Published date: 13 July 2022
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© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
Keywords:
Adult, COVID-19/complications, Ethnicity, Humans, Kidney, Multimorbidity, Prospective Studies, Risk Factors
Identifiers
Local EPrints ID: 470584
URI: http://eprints.soton.ac.uk/id/eprint/470584
ISSN: 1355-6037
PURE UUID: 31384b11-64d5-42ef-a5bc-228e06bae7e5
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Date deposited: 13 Oct 2022 16:42
Last modified: 08 Oct 2024 02:07
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Contributors
Author:
Tom Norris
Author:
Cameron Razieh
Author:
Francesco Zaccardi
Author:
Thomas Yates
Author:
Nazrul Islam
Author:
Clare L. Gillies
Author:
Yogini V. Chudasama
Author:
Alex V. Rowlands
Author:
Melanie J. Davies
Author:
Gerry P McCann
Author:
Amitava Banerjee
Author:
Carolyn S.P. Lam
Author:
Annemarie B. Docherty
Author:
Peter J.M. Openshaw
Author:
J. Kenneth Baillie
Author:
Malcolm Gracie Semple
Author:
Claire Alexandra Lawson
Author:
Kamlesh Khunti
Author:
Ahilanandan Dushianthan
Corporate Author: ISARIC4C Investigators
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