Association of Mortality-Related Risk Factors in Patients with COVID-19: A Retrospective Cohort Study

COVID-19 is a rapidly disseminating infectious disease conferred by the World Health Organization (WHO) as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics data have been identified for patients with COVID-19, but mortality-related risk factors and a comprehensive clinical course of disease in a developing country have not been specifically defined. This retrospective, single-center cohort study involved all successive inpatients having a positive COVID-19 polymerase chain reaction (PCR), with deceased or discharged clinical outcomes from 1 January to 10 May 2021. Data were extracted from electronic medical records on demographic, clinical, radiological, and laboratory findings as well as complications faced and treatment provided during follow-up, involving serial samples for viral RNA identification, and compared between the dead and survivors. To investigate the risk factors associated with in-hospital mortality, we employed the multivariate logistic regression model. In this study, 2048 patients were involved, 1458 of whom were discharged, and 590 died in hospital. More than half of patients were identified as male with old age being the potential risk factor of mortality. Exactly 94.8% of all patients presented with fever at the time of admission. Several comorbidities were present in the study population, with the most frequent comorbidity being cardiovascular diseases (1177 of 2048) and hypertension (975 of 2048) followed by cerebrovascular disease and diabetes mellitus. Mortality rates for infected patients were observed as higher in severe patients (46.3%) compared with non-severe cases (26.1%) during a follow-up. Multivariate regression analysis showed a significant association of in-hospital mortality of patients with older age, presence of hypertension and cardiovascular diseases as underlying comorbidities, increased level of cardiac troponin I and d-dimer concentration on admission, as well as septicemia and ARDS as a complication during illness. To minimize the risk of death in COVID19 patients, as well as the risk of severe complications, urgent public health measures should be properly planned and implemented on those vulnerable populations. To detect early manifestations of clinical problems, thorough and regular follow-up is warranted.

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Risk factors for myocardial injury and death in patients with COVID-19: insights from a cohort study with chest computed tomography

Cardiovascular Research ◽

10.1093/cvr/cvaa193 ◽

2020 ◽

Vol 116 (14) ◽

pp. 2239-2246 ◽

Cited By ~ 3

Author(s):

Giuseppe Ferrante ◽

Fabio Fazzari ◽

Ottavia Cozzi ◽

Matteo Maurina ◽

Renato Bragato ◽

...

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Cohort Study ◽

Myocardial Injury ◽

Troponin I ◽

Cox Regression ◽

Chest Ct ◽

Chest Computed Tomography ◽

Risk Of Death ◽

Increased Risk

Abstract Aims Whether pulmonary artery (PA) dimension and coronary artery calcium (CAC) score, as assessed by chest computed tomography (CT), are associated with myocardial injury in patients with coronavirus disease 2019 (COVID-19) is not known. The aim of this study was to explore the risk factors for myocardial injury and death and to investigate whether myocardial injury has an independent association with all-cause mortality in patients with COVID-19. Methods and Results This is a single-centre cohort study including consecutive patients with laboratory-confirmed COVID-19 undergoing chest CT on admission. Myocardial injury was defined as high-sensitivity troponin I >20 ng/L on admission. A total of 332 patients with a median follow-up of 12 days were included. There were 68 (20.5%) deaths; 123 (37%) patients had myocardial injury. PA diameter was higher in patients with myocardial injury compared with patients without myocardial injury [29.0 (25th–75th percentile, 27–32) mm vs. 27.7 (25–30) mm, P < 0.001). PA diameter was independently associated with an increased risk of myocardial injury [adjusted odds ratio 1.10, 95% confidence interval (CI) 1.02–1.19, P = 0.01] and death [adjusted hazard ratio (HR) 1.09, 95% CI 1.02–1.17, P = 0.01]. Compared with patients without myocardial injury, patients with myocardial injury had a lower prevalence of a CAC score of zero (25% vs. 55%, P < 0.001); however, the CAC score did not emerge as a predictor of myocardial injury by multivariable logistic regression. Myocardial injury was independently associated with an increased risk of death by multivariable Cox regression (adjusted HR 2.25, 95% CI 1.27–3.96, P = 0.005). Older age, lower estimated glomerular filtration rate, and lower PaO2/FiO2 ratio on admission were other independent predictors for both myocardial injury and death. Conclusions An increased PA diameter, as assessed by chest CT, is an independent risk factor for myocardial injury and mortality in patients with COVID-19. Myocardial injury is independently associated with an approximately two-fold increased risk of death.

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INFLUENCE OF RISK FACTORS FOR CARDIOVASCULAR DISEASES, HISTORY OF CARDIOVASCULAR DISEASES, AND STRUCTURAL AND FUNCTIONAL STATE OF THE HEART ON 3-YEAR SURVIVAL IN PERSONS 95 YEARS AND OLDER

Успехи геронтологии ◽

10.34922/ae.2021.34.5.009 ◽

2021 ◽

pp. 727-733

Author(s):

К.А. Ерусланова ◽

А.В. Лузина ◽

Ю.С. Онучина ◽

В.С. Остапенко ◽

Н.В. Шарашкина ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Diseases ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Risk Of Death ◽

History Of ◽

The Right

В последние годы появляется все больше работ, посвященных снижению воздействия классических факторов риска, негативно сказывающихся на выживаемости с возрастом. Целью исследования была оценка влияния сердечно-сосудистых заболеваний, их факторов риска и структурно-функциональных характеристик сердца на трехлетнюю выживаемость лиц 95 лет и старше. В исследовании участвовали 69 пациентов 95 лет и старше (98±1,9 года), из них 61 (88,4 %) женщина и 8 (11,6 %) мужчин. Через 3 года были получены данные о статусе жизни участников: 25 (36,2 %) были живы и 44 (63,8 %) умерли. По результатам проведенного однофакторного регрессионного анализа было определено, что факторы риска и анамнез сердечно-сосудистых заболеваний не ассоциированы с трехлетней выживаемостью. Однако в трехлетнем периоде риск смерти увеличивался в 3 раза при снижении ДАД <75 мм рт. ст., в 7,8 раза - при снижении ФВ ЛЖ <62 % и в 4,9 раза - при увеличении конечного диастолического размера правого желудочка >2,9 см. In recent years, more and more works have appeared that with age, classic risk factors that negatively affect the prognosis (cardiovascular diseases) lose their influence on life expectancy. The study aimed to assess the influence of cardiovascular diseases and their risk factors and structural and functional characteristics of the heart on three-year survival in people 95 years and older. The study involved 69 patients 95 years and older (98±1,9 years), 61 (88,4 %) were women. After 36 months, data were obtained on the participants’ status of life: 25 (36,2 %) were alive, and 44 (63,8 %) died. Based on the regression analysis results, it was determined that risk factors and history of cardiovascular diseases were not associated with 3-year survival. With a 3-year follow-up, the risk of death increases three times with a decrease in diastolic blood pressure less than 75 mm/Hg, 7,8 times with a decrease in left ventricular ejection fraction below 62 %, and 4,9 times with an increase in the end-diastolic size of the right ventricle by more than 2,9 cm.

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Risk factors, predictions, and progression of acute kidney injury in hospitalized COVID-19 patients: An observational retrospective cohort study

PLoS ONE ◽

10.1371/journal.pone.0257253 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0257253

Author(s):

Maryam N. Naser ◽

Rana Al-Ghatam ◽

Abdulla H. Darwish ◽

Manaf M. Alqahtani ◽

Hajar A. Alahmadi ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Cohort Study ◽

Serum Albumin ◽

Troponin I ◽

Cardiac Injury ◽

Kidney Injury ◽

Multivariate Regression Analysis ◽

Observational Cohort

Objectives Studies have shown that acute kidney injury (AKI) occurrence post SARS-CoV-2 infection is complex and has a poor prognosis. Therefore, more studies are needed to understand the rate and the predications of AKI involvement among hospitalized COVID-19 patients and AKI’s impact on prognosis while under different types of medications. Patients and methods This study is a retrospective observational cohort study conducted at Bahrain Defence Force (BDF) Royal Medical Services. Medical records of COVID-19 patients admitted to BDF hospital, treated, and followed up from April 2020 to October 2020 were retrieved. Data were analyzed using univariate and multivariate logistic regression with covariate adjustment, and the odds ratio (OR) and 95% confidence (95% CI) interval were reported. Results Among 353 patients admitted with COVID-19, 47.6% developed AKI. Overall, 51.8% of patients with AKI died compared to 2.2% of patients who did not develop AKI (p< 0.001 with OR 48.6 and 95% CI 17.2–136.9). Besides, deaths in patients classified with AKI staging were positively correlated and multivariate regression analysis revealed that moderate to severe hypoalbuminemia (<32 g/L) was independently correlated to death in AKI patients with an OR of 10.99 (CI 95% 4.1–29.3, p<0.001). In addition, 78.2% of the dead patients were on mechanical ventilation. Besides age as a predictor of AKI development, diabetes and hypertension were the major risk factors of AKI development (OR 2.04, p<0.01, and 0.05 for diabetes and hypertension, respectively). Also, two or more comorbidities substantially increased the risk of AKI development in COVID-19 patients. Furthermore, high levels upon hospital admission of D-Dimer, Troponin I, and ProBNP and low serum albumin were associated with AKI development. Lastly, patients taking ACEI/ARBs had less chance to develop AKI stage II/III with OR of 0.19–0.27 (p<0.05–0.01). Conclusions The incidence of AKI in hospitalized COVID-19 patients and the mortality rate among AKI patients were high and correlated with AKI staging. Furthermore, laboratory testing for serum albumin, hypercoagulability and cardiac injury markers maybe indicative for AKI development. Therefore, clinicians should be mandated to perform such tests on admission and follow-up in hospitalized patients.

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Cardiovascular diseases and related risk factors accelerated cognitive deterioration in patients with late-life depression: a one-year prospective study

International Psychogeriatrics ◽

10.1017/s1041610218002041 ◽

2019 ◽

Vol 31 (10) ◽

pp. 1483-1489 ◽

Cited By ~ 1

Author(s):

Xiaomei Zhong ◽

Zhangying Wu ◽

Cong Ouyang ◽

Wanyuan Liang ◽

Ben Chen ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Late Life ◽

Reliable Change Index ◽

Cognitive Deterioration ◽

Late Life Depression ◽

Short Term ◽

Related Risk ◽

One Year

ABSTRACTObjectives:Cognitive impairment in late-life depression is common and associated with a higher risk of all-cause dementia. Late-life depression patients with comorbid cardiovascular diseases (CVDs) or related risk factors may experience higher risks of cognitive deterioration in the short term. We aim to investigate the effect of CVDs and their related risk factors on the cognitive function of patients with late-life depression.Methods:A total of 148 participants were recruited (67 individuals with late-life depression and 81 normal controls). The presence of hypertension, coronary heart disease, diabetes mellitus, or hyperlipidemia was defined as the presence of comorbid CVDs or related risk factors. Global cognitive functions were assessed at baseline and after a one-year follow-up by the Mini-Mental State Examination (MMSE). Global cognitive deterioration was defined by the reliable change index (RCI) of the MMSE.Results:Late-life depression patients with CVDs or related risk factors were associated with 6.8 times higher risk of global cognitive deterioration than those without any of these comorbidities at a one-year follow-up. This result remained robust after adjusting for age, gender, and changes in the Hamilton Depression Rating Scale (HAMD) scores.Conclusions:This study suggests that late-life depression patients with comorbid CVDs or their related risk factors showed a higher risk of cognitive deterioration in the short-term (one-year follow up). Given that CVDs and their related risk factors are currently modifiable, active treatment of these comorbidities may delay rapid cognitive deterioration in patients with late-life depression.

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Radon and risk of death from cancer and cardiovascular diseases in the German uranium miners cohort study: follow-up 1946–2003

Radiation and Environmental Biophysics ◽

10.1007/s00411-009-0249-5 ◽

2009 ◽

Vol 49 (2) ◽

pp. 177-185 ◽

Cited By ~ 58

Author(s):

Michaela Kreuzer ◽

B. Grosche ◽

M. Schnelzer ◽

A. Tschense ◽

F. Dufey ◽

...

Keyword(s):

Cohort Study ◽

Cardiovascular Diseases ◽

Risk Of Death ◽

Uranium Miners

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Distribution of Cancer cases and survival analysis results: A retrospective cohort study

European Journal of Public Health ◽

10.1093/eurpub/ckz185.123 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

E Pehlivan ◽

B Mete ◽

V Söyiler

Keyword(s):

Cohort Study ◽

Survival Analysis ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

World Health ◽

Cox Regression Analysis ◽

Risk Of Death ◽

Incidence Of Cancer ◽

The Mean

Abstract Background Cancer was the second leading cause of death in Turkey. The aim of this study is to examine the changes in the incidence of cancer cases and survival analysis in a region. Methods This retrospective cohort study was carried out on data of 977 people had been diagnosed with cancer between the years 2013-2015 in Bingol province located in the east of Turkey. All cancer cases are included in the study. The data of the patients were obtained from the Ministry of Health Cancer Registry System and International Disease Classification Oncology (ICD-O) codes published by World Health Organization were used. Patients were evaluated topographically (tissue originating from the lesion) in 41 categories. Kruskal Wallis, Mann Whitney U test, Chi-square test and Cox regression analysis were used to analyze the data. Results The mean age of the patients was 58.73 ± 16.80 (min: 1-max: 107). It was observed that 28.7% of the patients died during the follow-up period and 71.3% of the patients were alive. 30% of the cancer cases digestive system, 11% respiratory system, 23% female breast- genitalia, 15% blood-lymph-thyroid, 11.8% muscle-bone, 15,4% other cancer species. In men, lung, stomach, colon, prostate; breast, thyroid and skin cancers are more common in women respectively. The incidence rate for all age groups was 97 per hundred thousand in 2013, 161 per hundred thousand in 2015. The increase trend did not differ by gender. The mean follow-up period of the patients who died was 388 days and 1541 days for the living patients. The risk of death is increased significantly in patients who cannot be operated (RR = 2.779, HR = 3.048). In patients not receiving chemotherapy, the risk of death is reduced significantly (RR = 0.656, HR = 0.340). Conclusions The incidence of cancer increases in the study area. Survival times vary according to treatment efficacy. Broad-based cohort studies evaluating the effects of treatment types on survival may be recommended. Key messages Cancer in the study area shows a significant increase from year to year. The average 5-year survival period of cancer patients was found is 71% as a good result.

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COVID-19 lockdown may increase cardiovascular disease risk factors

The Egyptian Heart Journal ◽

10.1186/s43044-020-00127-4 ◽

2021 ◽

Vol 73 (1) ◽

Author(s):

Daha Garba Muhammad ◽

Ibrahim Ahmad Abubakar

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Mortality Rate ◽

Disease Risk ◽

Communicable Disease ◽

Cardiovascular Disease Risk ◽

World Health ◽

Main Body ◽

Risk Of Death ◽

Increased Risk

Abstract Background Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) and was declared a worldwide pandemic by the World Health Organization (WHO) on 11 March 2020 which is leading to significant morbidity and mortality. In compliance with WHO recommendation of movement restrictions, many countries have imposed compulsory self-quarantine and restricted movements of their citizenries (lockdown/sit at home) and closure of businesses and borders as preventive measures to the fast-spreading virus. Consequently, this decision has made the emergence of behaviors that are detrimental to cardiovascular diseases (CVDs) which are the leading cause of the global mortality rate. Main body The increase in sedentary lifestyles, alcohol consumption, and substance abuse during COVID-19 pandemic lockdown as a result of personal restrictions in COVID-19 lockdown is linked with the risk of death from chronic diseases such as cardiovascular diseases (CVDs). Conclusion The lockdown has increased risk factors of CVDs, and as such, there might be an increase in the number of non-communicable disease (NCD)-related mortality rate. The effect does not end during the period of coronavirus pandemic but even after the pandemic.

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Abstract P008: Ultra-Sensitive Troponin I Strongly Predicts Incident Coronary Heart Disease in the General Population Independently of Traditional Risk Factors. Results From the MONICA/KORA Augsburg Case-Cohort Study

Circulation ◽

10.1161/circ.129.suppl_1.p008 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Wolfgang Koenig ◽

Astrid Zierer ◽

Mahir Karakas ◽

Christa Meisinger ◽

Annette Peters ◽

...

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Cohort Study ◽

Heart Disease ◽

Troponin I ◽

Geometric Mean ◽

Population Based ◽

Men And Women ◽

Traditional Risk Factors

Background: High-sensitive (hs) troponin T and I assays as well as ultrasensitive (us) troponin I enable measurement of troponins in 65% to 98% of the general population. We prospectively investigated whether increased concentrations of us-troponin I are associated with an increased risk of coronary heart disease (CHD) after controlling for traditional risk factors. Methods: We conducted a population-based case cohort study in middle-aged healthy men and women within the MONICA/KORA Augsburg studies. Serum levels of us-troponin I (Single Molecule Counting technology, Singulex) were available in 2,745 men and women including 803 incident CHD cases. Geometric mean us-troponin I was 1.56 ng/L. Mean (SD) follow-up was 16.0 (5.8) years. Results: Baseline concentrations of us-troponin I were higher in cases compared to non-cases (geometric mean 2.56 vs. 1.49 ng/L, p<0.0001) and in men compared to women (geometric mean 1.93 vs. 1.27 ng/L, p<0.0001). After adjustment for variables of the Framingham Risk Score, the hazard ratio (HR) with 95% confidence interval (CI) for a CHD event in the top quartile compared to the bottom quartile was 2.76 (95% CI, 1.87-4.09). After additional adjustment for alcohol intake, physical activity, and body mass index, hazard ratios remained essentially unchanged. Conclusions: Troponin I measured by an us-assay was detectable in almost all subjects. This is the first population-based prospective study with long-term follow-up showing that even modestly increased concentrations of us troponin I are strongly associated with incident CHD independently of a variety of traditional risk factors.

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Military-related risk factors in female veterans and risk of dementia

Neurology ◽

10.1212/wnl.0000000000006778 ◽

2018 ◽

Vol 92 (3) ◽

pp. e205-e211 ◽

Cited By ~ 11

Author(s):

Kristine Yaffe ◽

Sandy J. Lwi ◽

Tina D. Hoang ◽

Feng Xia ◽

Deborah E. Barnes ◽

...

Keyword(s):

Risk Factors ◽

Proportional Hazards ◽

The United States ◽

Female Veterans ◽

Veterans Health ◽

Medical Conditions ◽

Health Administration ◽

Risk Of Death ◽

Related Risk

ObjectiveTo determine whether diagnoses of traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and depression, alone or in combination, increase dementia risk among older female veterans.MethodsThis cohort study included data from 109,140 female veterans ≥55 years of age receiving care from Veterans Health Administration medical centers in the United States between October 2004 and September 2015 with at least 1 follow-up visit. TBI, PTSD, depression, and medical conditions at study baseline and incident dementia were determined according to ICD-9-CM codes. Fine-Gray proportional hazards models were used to determine the association between military-related risk factors and dementia diagnosis, accounting for the competing risk of death.ResultsDuring follow-up (mean 4.0 years, SD 2.3), 4% of female veterans (n = 4,125) developed dementia. After adjustment for demographics and medical conditions, women with TBI, PTSD, and depression had a significant increase in risk of developing dementia compared to women without these diagnoses (TBI-adjusted subdistribution hazard ratio [adjusted sHR] 1.49, 95% confidence interval [CI] 1.01–2.20; PTSD adjusted sHR 1.78, 95% CI 1.34–2.36; and depression-adjusted sHR 1.67, 95% CI 1.55–1.80), while women with >1 diagnosis had the highest risk for dementia (adjusted sHR 2.15, 95% CI 1.84–2.51).ConclusionsWe found that women with military-related risk factors had an ≈50% to 80% increase in developing dementia relative to women without these diagnoses, while female veterans with multiple risk factors had a >2-fold risk of developing dementia. These findings highlight the need for increased screening of TBI, PTSD, and depression in older women, especially female veterans.

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