scholarly journals The characteristics and death risk factors of 132 COVID-19 pneumonia patients with comorbidities: a retrospective single center analysis in Wuhan, China

Author(s):  
Chen Chen ◽  
Jingyi Zhang ◽  
Chang Li ◽  
Zhishuo Hu ◽  
Ming Zhang ◽  
...  

AbstractBackgroundThe new coronavirus pneumonia (COVID-19) has evolved into a global pandemic disease, and the epidemiological characteristics of the disease have been reported in detail. However, many patients with new coronary pneumonia have comorbidities, and there are few researches reported in this special population.Methodsa retrospective analysis was performed on 132 consecutive COVID-19 patients with comorbidities from January 19, 2020 to March 7, 2020 in Hubei Third People’s Hospital. Patients were divided into mild group and critical group and were followed up to the clinical endpoint. The observation biomarkers include the clinical feature, blood routine, blood biochemistry, inflammation biomarkers, and coagulation function. Univariate and multivariate logistic regression was used to analyze the risk factors associated with death.Results132 patients were enrolled in this study and divided into the mild group (n=109, 82.6%) and critical group (n=23, 17.4%), of whom 119 were discharged and 13 were died in hospital. The all-cause mortality rate was 9.8%, of which 7 patients died of respiratory failure, 5 patients died of heart failure, and 1patient died of chronic renal failure. There was significant statistical difference of mortality rates between the mild group (5.5%) and the critical group (30.4%). The average time of hospitalization was 16.9 (9, 22) days. Hypertension was the most common comorbidity (n=90, 68.2%), followed by diabetes (n=45, 34.1%), coronary heart disease (31, 23.5%). Compared with the mild group, the patients were older in critical group (P <0.05), and neutrophils, neutrophil ratio, neutrophil-lymphocyte ratio (NLR), serum urea nitrogen (BUN), procalcitonin (PCT), C-reactive protein CRP), serum amyloid protein (SSA), N-terminal brain natriuretic peptide precursor (NT-pro BNP) were significantly increased (P <0.05). However, lymphocytes lymphocyte ratio, albumin were lower than those in the critical group (P <0.05). The patients were further divided into the survivor group (n=119, 90.2%) and the non-survivor group (n=13, 9.8%). Compared with the survivor group, the death rate of patients with coronary heart disease was significantly increased (53.8% vs 20.2%), and The neutrophil ratio, aspartate aminotransferase (AST), BUN, PCT, CRP, SAA, interleukin-6(IL-6) and D-dimer were significantly increased (P <0.05), while the lymphocytes and NLR reduced (P <0.05). Multivariate logistic stepwise regression analysis showed that the past medical history of coronary heart disease[OR:2.806 95%CI:0.971~16.795], decreased lymphocytes [OR: 0.040, 95%CI:0.001~2.306], increased AST[OR:1.026, 95%CI:1.000~1.052], increased SSA[OR:1.021, 95%CI:1.001~1.025], and increased D-dimer[OR:1.231, 95%CI:1.042~1.456] are risk factors associated with death in COVID-19 patients pneumonia with comorbidities.ConclusionThe mortality rate of COVID-19 patients with coronary heart disease is relatively high. In all patients, the lower lymphocytes, and higher NLR, BUN, PCT, CRP, SSA, D-dimer are significant characteristics. The past medical history of coronary heart disease, decreased lymphocytes, increased AST, SSA and D-dimer are risk factors associated with death in COVID-19 patients’ pneumonia with comorbidities

2020 ◽  
Author(s):  
Hang Yang ◽  
RUI GUO ◽  
Lincheng Yang ◽  
Ruitao Zhang ◽  
Yunpeng Ling ◽  
...  

Abstract Background: In addition to the lungs, the coronavirus disease 2019 (COVID-19) also affects multiple organs throughout the body. The relationship between COVID-19 infection and cardiovascular disease, and the mechanisms by which this disease causes damage to the cardiovascular system are unclear. Coronary heart disease (CHD) is one of the common comorbidities of COVID-19, but there is insufficient evidence for its clinical features and impact on clinical outcomes. The aim of this study was to analyze the clinical characteristics of COVID-19 patients with comorbid CHD and the possible risk factors for the occurrence of critical illness. Methods: A single-center, retrospective study was conducted to analyze COVID-19 patients admitted to the Sino-French New City Campus of Tongji Hospital in Wuhan, Hubei Province and treated by the Peking University National Medical Assistance Team between January 29 and March 10, 2020. Patients testing positive for SARS-CoV-2 viral nucleic acid in nasopharyngeal swab specimens and who had comorbid CHD, were included in the study. Clinical data and laboratory test results of eligible patients were collected, and the factors associated with the occurrence of critical illness among these patients were evaluated. Results: A total of 205 patients were enrolled in this study, including 20 CHD patients and 185 non-CHD patients. The mean age was 66.7 years. Compared to non-CHD patients, more CHD patients had comorbid hypertension and diabetes (P < 0.05). In terms of laboratory tests, the CHD group did not differ significantly from the non-CHD group in blood routine, blood chemistry, and various inflammatory cytokines. More CHD patients experienced myocardial injury (25% vs 8.1% P < 0.031) and CHD patients were more likely to progress to critical illness (40% vs 16.8%P = 0.012). Univariate logistic regression analysis indicated that a history of CHD, occurrence of myocardial injury, high white blood cell (WBC) count, low lymphocyte count, and elevated levels of Cr, ferritin, IL-2R, IL-8 at admission were factors associated with the occurrence of critical illness. Multivariate regression analysis found that a history of CHD(OR=3.529, 95% CI =1.032-12.075, P =0.044),high WBC count(OR=1.289, 95% CI =1.136-1.463, P<0.001) and low lymphocyte count(OR=0.215, 95% CI =0.075-0.616, P =0.004)were independent factors for the occurrence of critical illness among COVID-19 patients. Conclusion: COVID-19 patients with comorbid CHD commonly exhibited myocardial injury and were prone to developing critical illness. Among COVID-19 patients, a history of CHD,high WBC count and low lymphocyte count were independent risk factors for the occurrence of critical illness. Greater attention and vigilance are needed in this regard during clinical practice.


2020 ◽  
Vol 1 (1) ◽  
pp. 21-30
Author(s):  
Deviana Widayanti ◽  
Chatarina Setya Widyastuti

Background: Coronary Heart Disease (CHD) Is a condition when the arteries that supply blood to the heart wall experience hardening and narrowing. It is estimated that 30% of coronary heart disease causes death worldwide. Objective: This study aims to determine the risk factors for CHD in Panti Rapih Hospital. Methods: This descriptive study aims to determine the risk factors for CHD in outpatients at Panti Rapih Hospital. The population is patients who have been diagnosed with coronary heart disease and the sample was taken by 50 respondents with non-random accidental sampling technique. This research take the data use questionnaire and make univariat analysis. Results: Risk factors for CHD are a number of factors that cannot be changed: family history of 42%, age = 40 years 95% in men and 95% age = 65 years in women. Factors that can be changed are: Smoking 78%, history of hypertension 68%, history of diabetes mellitus 28%, dyslipidemic 90%, excess body weight42% and lack of exercise 38%. Conclusion: Risk factors for CHD that cannot be changed: family history of 42%, age = 40 years 95% in men and 95% age = 65 years in women. Factors that can be changed are: Smoking 78%, history of hypertension 68%, history of diabetes mellitus 28%, dyslipidemic 90%, excess body weight 42% and lack of exercise 38%.     Keywords: coronary heart disease, risk factors


2011 ◽  
Vol 65 (Suppl 1) ◽  
pp. A342-A342
Author(s):  
P. Joshi ◽  
R. Kumari ◽  
M. Z. Idris ◽  
N. Ahmad ◽  
R. K. Saran ◽  
...  

Circulation ◽  
2003 ◽  
Vol 107 (9) ◽  
pp. 1260-1264 ◽  
Author(s):  
Debbie A. Lawlor ◽  
Jonathan R. Emberson ◽  
Shah Ebrahim ◽  
Peter H. Whincup ◽  
S. Goya Wannamethee ◽  
...  

2016 ◽  
Vol 43 (2) ◽  
pp. 51
Author(s):  
Murti Andriastuti ◽  
Sudigdo Sastroasmoro ◽  
Agus Firmansyah

Background Morbidity and mortality of coronary heart disease(CHD) are recently increasing. This is related to changes in lifestyle,such as lack of activity and high consumption of fatty diet. Themain cause of CHD is atherosclerosis. The development of ath-erosclerosis takes a long time, is asymptomatic, and might beginin childhood. The important risk factors that have roles in increas-ing the likelihood of atherosclerosis are family history of prematureCHD, hypertension, hyperlipidemia, obesity, smoking and irregu-lar activity.Objective The aim of this study was to find out the prevalence ofCHD risk factors in children and young adults who had parentalhistory of premature CHD.Methods This was a descriptive cross sectional study conductedon offspring of premature CHD patients who were admitted in theintensive cardiology care unit (ICCU) of Cipto MangunkusumoHospital between January 1999 to December 2001 and of prema-ture CHD patients who visited the Cardiology Clinic of the Depart-ment of Internal Medicine, Cipto Mangunkusumo Hospital duringMarch and April 2002. Subjects were aged 12 to 25 year-old.Results Among the subjects, 40% had hyperlipidemia, 8% hadhypertension, 11% were obese, 21% were active smokers, 41%were passive smokers, and 73% had irregular activity. Ninety-sevenpercents subjects had more than 1 risk factors.Conclusions The prevalence of hyperlipidemia, hypertension,obesity, passive smoker, active smoker and irregular activity inchildren and young adults with parental history of premature CHDin this study were higher than those in the normal population.Most had more than 1 risk factor, increasing the likelihood of CHD.A screening test should be performed on children with parentalhistory of premature CHD so that early preventive measures mightbe done to minimize the risk factors


2023 ◽  
Vol 83 ◽  
Author(s):  
R. Muzaffar ◽  
M. A. Khan ◽  
M. H. Mushtaq ◽  
M. Nasir ◽  
A. Khan ◽  
...  

Abstract The present study was designed to evaluate the strength of association of raised plasma homocysteine concentration as a risk factor for coronary heart disease independent of conventional risk factor. It was a case control study conducted at Punjab Institute of Cardiology Lahore. A total of 210 subjects aged 25 to 60 years comprising of 105 newly admitted patients of CHD as cases and 105 age and sex matched healthy individuals with no history of CHD as control were recruited for the study. Fasting blood samples were obtained from cases and controls. Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) method on automated immunoassay analyzer (Abbott IMX). Total cholesterol, triglyceride and HDL cholesterol were analyzed using calorimetric kit methods. The concentration of LDL cholesterol was calculated using Friedewald formula. The patients were also assessed for traditional risk factors such as age, sex, family history of CVD, hypertension, smoking and physical activity, and were compared with control subjects. The collected data was entered in SPSS version 24 for analysis and interpretation.The mean age in controls and experimental groups were 43.00± 8.42 years and 44.72± 8.59 years with statistically same distribution (p- value= 0.144). The mean plasma homocysteine for cases was 22.33± 9.22 µmol/L where as it was 12.59±3.73 µmol/L in control group. Highly significant difference was seen between the mean plasma level of homocysteine in cases and controls (p˂0.001).Simple logistic regression indicates a strong association of coronary heart disease with hyperhomocysteinemia (OR 7.45), which remained significantly associated with coronary heart disease by multivariate logistic regression (OR 7.10, 95%C1 3.12-12.83, p=0.000). The present study concludes that elevated levels of Plasma homocysteine is an independent risk factor for coronary heart disease independent of conventional risk factors and can be used as an indicator for predicting the future possibility for the onset of CVD.


Author(s):  
Lynne T. Shuster ◽  
Deborah J. Rhodes

The science and practice of women's health have evolved considerably during the past 15 years. Increasingly, internal medicine physicians are expected to manage diseases and conditions unique to women (like menstruation, menopause, and pregnancy), more prevalent (contraception, infertility, breast conditions) or more serious in women, or for which risk factors or interventions are different in women than in men (coronary heart disease). Domestic violence issues are also reviewed.


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