Abstract 041: Cardiovascular Disease, Hypertension, Diabetes And Cystatin C Jointly Predict Covid-19 Mortality Alongside Age, Male Sex And Black Ethnicity

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Joshua Elliott ◽  
Barbara Bodinier ◽  
Matthew Whitaker ◽  
Ioanna Tzoulaki ◽  
Paul Elliott ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Stability Analysis ◽  
Cystatin C ◽  
Penalized Regression ◽  
Pressure Control ◽  
Stability Selection ◽  
Selection Threshold ◽  
Male Sex ◽  
Sparse Set

Introduction: Studies of risk factors for severe/fatal COVID-19 to date may not have identified the optimal set of informative predictors. Hypothesis: Use of penalized regression with stability analysis may identify new, sparse sets of risk factors jointly associated with COVID-19 mortality. Methods: We investigated demographic, social, lifestyle, biological (lipids, cystatin C, vitamin D), medical (comorbidities, medications) and air pollution data from UK Biobank (N=473,574) in relation to linked COVID-19 mortality, and compared with non-COVID-19 mortality. We used penalized regression models (LASSO) with stability analysis (80% selection threshold from 1,000 models with 80% subsampling) to identify a sparse set of variables associated with COVID-19 mortality. Results: Among 43 variables considered by LASSO stability selection, cardiovascular disease, hypertension, diabetes, cystatin C, age, male sex and Black ethnicity were jointly predictive of COVID-19 mortality risk at 80% selection threshold (Figure). Of these, Black ethnicity and hypertension contributed to COVID-19 but not non-COVID-19 mortality. Conclusions: Use of LASSO stability selection identified a sparse set of predictors for COVID-19 mortality including cardiovascular disease, hypertension, diabetes and cystatin C, a marker of renal function that has also been implicated in atherogenesis and inflammation. These results indicate the importance of cardiometabolic comorbidities as predisposing factors for COVID-19 mortality. Hypertension was differentially highly selected for risk of COVID-19 mortality, suggesting the need for continued vigilance with good blood pressure control during the pandemic.

scholarly journals COVID-19 mortality in the UK Biobank cohort: revisiting and evaluating risk factors

2021 ◽  
Vol 36 (3) ◽  
pp. 299-309 ◽  
Author(s):  
Joshua Elliott ◽  
Barbara Bodinier ◽  
Matthew Whitaker ◽  
Cyrille Delpierre ◽  
Roel Vermeulen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Vitamin D ◽  
Regression Models ◽  
Oral Steroid ◽  
Uk Biobank ◽  
Steroid Use ◽  
Increased Risk ◽  
Male Sex

AbstractMost studies of severe/fatal COVID-19 risk have used routine/hospitalisation data without detailed pre-morbid characterisation. Using the community-based UK Biobank cohort, we investigate risk factors for COVID-19 mortality in comparison with non-COVID-19 mortality. We investigated demographic, social (education, income, housing, employment), lifestyle (smoking, drinking, body mass index), biological (lipids, cystatin C, vitamin D), medical (comorbidities, medications) and environmental (air pollution) data from UK Biobank (N = 473,550) in relation to 459 COVID-19 and 2626 non-COVID-19 deaths to 21 September 2020. We used univariate, multivariable and penalised regression models. Age (OR = 2.76 [2.18–3.49] per S.D. [8.1 years], p = 2.6 × 10–17), male sex (OR = 1.47 [1.26–1.73], p = 1.3 × 10–6) and Black versus White ethnicity (OR = 1.21 [1.12–1.29], p = 3.0 × 10–7) were independently associated with and jointly explanatory of (area under receiver operating characteristic curve, AUC = 0.79) increased risk of COVID-19 mortality. In multivariable regression, alongside demographic covariates, being a healthcare worker, current smoker, having cardiovascular disease, hypertension, diabetes, autoimmune disease, and oral steroid use at enrolment were independently associated with COVID-19 mortality. Penalised regression models selected income, cardiovascular disease, hypertension, diabetes, cystatin C, and oral steroid use as jointly contributing to COVID-19 mortality risk; Black ethnicity, hypertension and oral steroid use contributed to COVID-19 but not non-COVID-19 mortality. Age, male sex and Black ethnicity, as well as comorbidities and oral steroid use at enrolment were associated with increased risk of COVID-19 death. Our results suggest that previously reported associations of COVID-19 mortality with body mass index, low vitamin D, air pollutants, renin–angiotensin–aldosterone system inhibitors may be explained by the aforementioned factors.

scholarly journals Association between socioeconomic position and cystatin C in the Heinz Nixdorf Recall Study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tanja Zamrik ◽  
Mirjam Frank ◽  
Carina Emmel ◽  
Lars Christian Rump ◽  
Raimund Erbel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cystatin C ◽  
Socioeconomic Position ◽  
Social Inequalities ◽  
Men And Women ◽  
Income Quartile ◽  
Age And Sex

AbstractSocial inequalities in health and disease are well studied. Less information is available on inequalities in biomarker levels indicating subclinical stages of disease such as cystatin C, an early diagnostic marker of renal dysfunction and predictor for cardiovascular disease. We evaluated the relationship between cystatin C, socioeconomic position (SEP) and established cardiovascular risk factors in a population-based study. In 4475 men and women aged 45–75 years participating in the baseline examination of the Heinz Nixdorf Recall Study cystatin C was measured from serum samples with a nephelometric assay. SEP was assessed by education and household income. Linear regression models were used to analyse the association between SEP and cystatin C as well as the impact of cardiovascular risk factors (i.e., body mass index, blood pressure, blood glucose, diabetes mellitus, blood lipids, C-reactive protein, smoking) on this association. After adjustment for age and sex cystatin C decreased by 0.019 mg/l (95% confidence interval (CI) − 0.030 to − 0.008) per five years of education. While using a categorical education variable cystatin C presented 0.039 mg/l (95% CI 0.017–0.061) higher in men and women in the lowest educational category (≤ 10 years of education) compared to the highest category (≥ 18 years). Concerning income, cystatin C decreased by 0.014 mg/l (95% CI − 0.021 to − 0.006) per 1000 € after adjustment for age and sex. For men and women in the lowest income quartile cystatin C was 0.024 mg/l (95% CI 0.009–0.038) higher compared to the highest income quartile. After adjusting for established cardiovascular risk factors the observed associations were substantially diminished. Social inequalities seem to play a role in subclinical stages of renal dysfunction, which are also related to development of cardiovascular disease. Adjustment for traditional cardiovascular risk factors showed that these risk factors largely explain the association between SEP and cystatin C.

scholarly journals The relationship of COVID-19 severity with cardiovascular disease and its traditional risk factors: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Kunihiro Matsushita ◽  
Ning Ding ◽  
Minghao Kou ◽  
Xiao Hu ◽  
Mengkun Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Meta Analysis ◽  
Multivariable Analysis ◽  
Renin Angiotensin System ◽  
Regression Analyses ◽  
Male Sex ◽  
Meta Regression ◽  
Traditional Risk Factors

AbstractBackgroundWhether cardiovascular disease (CVD) and its traditional risk factors predict severe coronavirus disease 2019 (COVID-19) is uncertain, in part, because of potential confounding by age and sex.MethodsWe performed a systematic review of studies that explored pre-existing CVD and its traditional risk factors as risk factors of severe COVID-19 (defined as death, acute respiratory distress syndrome, mechanical ventilation, or intensive care unit admission). We searched PubMed and Embase for papers in English with original data (≥10 cases of severe COVID-19). Using random-effects models, we pooled relative risk (RR) estimates and conducted meta-regression analyses.ResultsOf the 661 publications identified in our search, 25 papers met our inclusion criteria, with 76,638 COVID-19 patients including 11,766 severe cases. Older age was consistently associated with severe COVID-19 in all eight eligible studies, with RR >∼5 in >60-65 vs. <50 years. Three studies showed no change in the RR of age after adjusting for covariate(s). In univariate analyses, factors robustly associated with severe COVID-19 were male sex (10 studies; pooled RR=1.73, [95%CI 1.50-2.01]), hypertension (8 studies; 2.87 [2.09-3.93]), diabetes (9 studies; 3.20 [2.26-4.53]), and CVD (10 studies; 4.97 [3.76-6.58]). RR for male sex was likely to be independent of age. For the other three factors, meta-regression analyses suggested confounding by age. Only four studies reported multivariable analysis, but most of them showed adjusted RR ∼2 for hypertension, diabetes, and CVD. No study explored renin-angiotensin system inhibitors as a risk factor for severe COVID-19.ConclusionsDespite the potential for confounding, these results suggest that hypertension, diabetes, and CVD are independently associated with severe COVID-19 and, together with age and male sex, can be used to inform objective decisions on COVID-19 testing, clinical management, and workforce planning.

scholarly journals Risk Factors for Acute Kidney Injury in Adult Patients With COVID-19: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiaoyue Cai ◽  
Guiming Wu ◽  
Jie Zhang ◽  
Lichuan Yang
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Meta Analysis ◽  
Significant Risk ◽  
Kidney Injury ◽  
Adult Patients ◽  
Cochrane Library ◽  
Male Sex

Background and Objective: Since December 2019, coronavirus disease 2019 (COVID-19) has spread rapidly around the world. Studies found that the incidence of acute kidney injury (AKI) in COVID-19 patients was more than double the incidence of AKI in non-COVID-19 patients. Some findings confirmed that AKI is a strong independent risk factor for mortality in patients with COVID-19 and is associated with a three-fold increase in the odds of in-hospital mortality. However, little information is available about AKI in COVID-19 patients. This study aimed to analyse the risk factors for AKI in adult patients with COVID-19.Methods: A systematic literature search was conducted in PubMed, EMBASE, Web of Science, the Cochrane Library, CNKI, VIP and WanFang Data from 1 December 2019 to 30 January 2021. We extracted data from eligible studies to compare the effects of age, sex, chronic diseases and potential risk factors for AKI on the prognosis of adult patients with COVID-19.Results: In total, 38 studies with 42,779 patients were included in this analysis. The meta-analysis showed that male sex (OR = 1.37), older age (MD = 5.63), smoking (OR = 1.23), obesity (OR = 1.12), hypertension (OR=1.85), diabetes (OR=1.71), pneumopathy (OR = 1.36), cardiovascular disease (OR = 1.98), cancer (OR = 1.26), chronic kidney disease (CKD) (OR = 4.56), mechanical ventilation (OR = 8.61) and the use of vasopressors (OR = 8.33) were significant risk factors for AKI (P &lt; 0.05).Conclusions: AKI is a common and serious complication of COVID-19. Overall, male sex, age, smoking, obesity, hypertension, diabetes, pneumopathy, cardiovascular disease, cancer, CKD, mechanical ventilation and the use of vasopressors were independent risk factors for AKI in adult patients with COVID-19. Clinicians need to be aware of these risk factors to reduce the incidence of AKI.System Review Registration: PROSPERO, identifier [CRD42021282233].

Cardiovascular risk factor control among cancer survivors: A population-based survey

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6535-6535
Author(s):  
K. Enright ◽  
M. Krzyzanowska
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cancer Survivors ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Cardiac Risk ◽  
Cardiac Risk Factors ◽  
Significant Difference

6535 Background: Cardiovascular disease is a major cause of morbidity and mortality in long-term survivors of cancer. Whereas the burden of cardiovascular disease has been described in cancer survivors, the control of modifiable cardiovascular risk factors in this population is unknown. Methods: We used the National Health and Nutrition Examination Survey (NHANES 1999–2006) data to examine the rate of control of modifiable cardiac risk factors amongst US cancer survivors compared with propensity matched adult controls with no history of cancer. The modifiable cardiac risk factors (blood pressure, cholesterol, BMI, exercise, smoking) were considered to be controlled if they met the AHA/ACC guideline recommendations. Results: A total of 1,227 cancer survivors and 3,672 age, sex, and comorbidity matched controls were identified, representing 11.9 million cancer survivors and 31.2 million controls. Compared to age, sex and comorbidity matched controls cancer survivors were more likely to be current smokers (34.5% vs. 28.8%, p = 0.021), and more likely to have their BMI at target (32.8% vs. 28.6%, p = 0.034). There was no significant difference in the rate of blood pressure control (69.4% vs. 69.2%, p = 0.88), cholesterol control (47.6% vs. 48.2%, p = 0.80) or adherence to exercise recommendations (24.4% vs. 24.6%, p = 0.89). Younger cancer survivors (age 20–40 y) were 2.8 times more likely to be smokers than controls, whereas older cancer survivors (age 60–80y) were 1.2 times more likely to be smokers than controls. Compared with recent cancer survivors (10 years from diagnosis) were more likely to have optimal blood pressure control (73.3% vs. 65.5%, p = 0.02), however there was no difference in smoking rates, cholesterol, exercise or weight control with duration of cancer survival. Conclusions: Overall the control of modifiable cardiac risk factors was similar between survivors and controls, but was suboptimal in both groups. This study identified smoking cessation, particularly amongst young cancers survivors, as an important area of focus for improvement in survivorship care. No significant financial relationships to disclose.

scholarly journals Risk Factors for Mortality and Progression to Severe COVID-19 Disease in the Southeast United States (US): A Report from the SEUS Study Group

2021 ◽  
pp. 1-33 ◽  
Author(s):  
Athena L. V. Hobbs ◽  
Nicholas Turner ◽  
Imad Omer ◽  
Morgan K. Walker ◽  
Ronald M. Beaulieu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Mechanical Ventilation ◽  
Multivariate Analysis ◽  
Hospital Mortality ◽  
Mortality Risk ◽  
Severe Disease ◽  
Increased Risk ◽  
Male Sex ◽  
Southeast Us

Abstract Objective Identify risk factors that could increase progression to severe disease and mortality in hospitalized SARS-CoV-2 patients in the Southeast US. Design, Setting, and Participants Multicenter, retrospective cohort including 502 adults hospitalized with laboratory-confirmed COVID-19 between March 1, 2020 and May 8, 2020 within one of 15 participating hospitals in 5 health systems across 5 states in the Southeast US. Methods The study objectives were to identify risk factors that could increase progression to hospital mortality and severe disease (defined as a composite of intensive care unit admission or requirement of mechanical ventilation) in hospitalized SARS-CoV-2 patients in the Southeast US. Results A total of 502 patients were included, and the majority (476/502, 95%) had clinically evaluable outcomes. Hospital mortality was 16% (76/476), while 35% (177/502) required ICU admission, and 18% (91/502) required mechanical ventilation. By both univariate and adjusted multivariate analysis, hospital mortality was independently associated with age (adjusted odds ratio [aOR] 2.03 for each decade increase, 95% CI 1.56-2.69), male sex (aOR 2.44, 95% CI: 1.34-4.59), and cardiovascular disease (aOR 2.16, 95% CI: 1.15-4.09). As with mortality, risk of severe disease was independently associated with age (aOR 1.17 for each decade increase, 95% CI: 1.00-1.37), male sex (aOR 2.34, 95% CI 1.54-3.60), and cardiovascular disease (aOR 1.77, 95% CI 1.09-2.85). Conclusions In an adjusted multivariate analysis, advanced age, male sex, and cardiovascular disease increased risk of severe disease and mortality in patients with COVID-19 in the Southeast US. In-hospital mortality risk doubled with each subsequent decade of life.

scholarly journals Epidemiological characteristics of patients with severe COVID-19 infection in Wuhan, China: evidence from a retrospective observational study

2020 ◽  
Author(s):  
Fang Wang ◽  
Jinhong Cao ◽  
Yong Yu ◽  
Jianbo Ding ◽  
Ehab S Eshak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Disease ◽  
Critical Illness ◽  
Critically Ill ◽  
Cox Regression ◽  
Advanced Age ◽  
Male Sex ◽  
Susceptible Populations ◽  
Epidemiological Characteristics

Abstract Background The new coronavirus (COVID-19) rapidly resulted in a pandemic. We report the characteristics of patients with severe or critical severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Wuhan city, China, and the risk factors related to infection severity and death. Methods We extracted the demographic and clinical data of 7283 patients with severe COVID-19 infection from designated Wuhan hospitals as of 25 February 2020. Factors associated with COVID-19 critical illness and mortality were analysed using logistic- and Cox-regression analyses. Results We studied 6269 patients with severe COVID-19 illness and 1014 critically ill patients. The median (IQR) age was 64 (53–71) years; 51.2% were male, 38.9% were retirees and 7.4% had self-reported histories of chronic disease. Up to the end of the study, 1180 patients (16.2%) recovered and were discharged, 649 (8.9%) died and the remainder were still receiving treatment. The number of daily confirmed critical cases peaked between 23 January and 1 February 2020. Patients with advanced age [odds ratio (OR), 1.03; 95% confidence intervals (CIs), 1.03–1.04], male sex (OR, 1.57; 95% CI, 1.33–1.86) and pre-existing diabetes (OR, 2.11), hypertension (OR, 2.72), cardiovascular disease (OR, 2.15) or respiratory disease (OR, 3.50) were more likely to be critically ill. Compared with those who recovered and were discharged, patients who died were older [hazard ratio (HR), 1.04; 95% CI, 1.03–1.05], more likely to be male (HR, 1.74; 95% CI, 1.44–2.11) and more likely to have hypertension (HR, 5.58), cardiovascular disease (HR, 1.83) or diabetes (HR, 1.67). Conclusion Advanced age, male sex and a history of chronic disease were associated with COVID-19 critical illness and death. Identifying these risk factors could help in the clinical monitoring of susceptible populations.

scholarly journals Polymorphisms of the genes ABCG2, SLC22A12 and XDH and their relation with hyperuricemia and hypercholesterolemia in Mexican young adults

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 217
Author(s):  
Juan Manuel Vargas-Morales ◽  
Martha Guevara-Cruz ◽  
Celia Aradillas-García ◽  
Lilia G. Noriega ◽  
Armando Tovar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Logistic Regression ◽  
Genetic Polymorphisms ◽  
Biochemical Parameters ◽  
Pathological Condition ◽  
Predisposing Factors ◽  
Dominant Model ◽  
Factors Associated ◽  
Male Sex

Background: Hyperuricemia is a pathological condition associated with risk factors of cardiovascular disease. In this study, three genetic polymorphisms were genotyped as predisposing factors of hyperuricemia. Methods: A total of 860 Mexicans between 18 and 25 years of age were genotyped for the ABCG2 (rs2231142), SLC22A12 (rs476037), and XDH (rs1042039) polymorphisms, as predisposing factors of hyperuricemia. Biochemical parameters were measured by spectrophotometry, while genetic polymorphisms were analyzed by real-time PCR. An analysis of the risk of hyperuricemia in relation to the variables studied was carried out using a logistic regression. Results: Male sex, being overweight or obese, having hypercholesterolemia or having hypertriglyceridemia were factors associated with hyperuricemia (p ≤ 0.05). The ABCG2 polymorphism was associated with hyperuricemia (OR = 2.43, 95% CI: 1.41-4.17, p = 0.001) and hypercholesterolemia (OR = 4.89, 95% CI: 1.54-15.48, p = 0.003), employing a dominant model, but only in male participants. Conclusions: The ABCG2 (rs2231142) polymorphism increases the risk of hyperuricemia and hypercholesterolemia in young Mexican males.

scholarly journals Update on the management of vascular patients with COVID-19

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Grigoris T Gerotziafas ◽  
Mariella Catalano
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Arterial Thrombosis ◽  
Vascular Medicine ◽  
Short Summary ◽  
Male Sex ◽  
Frail Population

Attention has to be payed to patients with vascular disease (VD) cardiovascular risk factors (VD-CVR) and COVID-19. In fact, COVID-19 is also manifested with hypercoagulability, pulmonary intravascular coagulation, microangiopathy, and venous thromboembolism (VTE) or arterial thrombosis and VP are a frail population. Predisposing risk factors to severe COVID-19 are male sex, underlying cardiovascular disease, or cardiovascular risk factors including non-controlled diabetes mellitus or arterial hypertension, obesity, and advanced age. The VAS-European Independent Foundation in Angiology/Vascular Medicine has recently published an integral strategy for the management of patients with VD or cardiovascular risk factors (VD-CVR) and COVID-19. This paper represents a short summary.

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