Cardiovascular Risk Factors and Clinical Outcomes among Patients Hospitalized with COVID-19: Findings from the World Heart Federation COVID-19 Study.

Journal Article (Journal Article)

Background and aims: Limited data exist on the cardiovascular manifestations and risk factors in people hospitalized with COVID-19 from low- and middle-income countries. This study aims to describe cardiovascular risk factors, clinical manifestations, and outcomes among patients hospitalized with COVID-19 in low, lower-middle, upper-middle- and high-income countries (LIC, LMIC, UMIC, HIC). Methods: Through a prospective cohort study, data on demographics and pre-existing conditions at hospital admission, clinical outcomes at hospital discharge (death, major adverse cardiovascular events (MACE), renal failure, neurological events, and pulmonary outcomes), 30-day vital status, and re-hospitalization were collected. Descriptive analyses and multivariable log-binomial regression models, adjusted for age, sex, ethnicity/income groups, and clinical characteristics, were performed. Results: Forty hospitals from 23 countries recruited 5,313 patients with COVID-19 (LIC = 7.1%, LMIC = 47.5%, UMIC = 19.6%, HIC = 25.7%). Mean age was 57.0 (±16.1) years, male 59.4%, pre-existing conditions included: hypertension 47.3%, diabetes 32.0%, coronary heart disease 10.9%, and heart failure 5.5%. The most frequently reported cardiovascular discharge diagnoses were cardiac arrest (5.5%), acute heart failure (3.8%), and myocardial infarction (1.6%). The rate of in-hospital deaths was 12.9% (N = 683), and post-discharge 30 days deaths was 2.6% (N = 118) (overall death rate 15.1%). The most common causes of death were respiratory failure (39.3%) and sudden cardiac death (20.0%). The predictors of overall mortality included older age (≥60 years), male sex, pre-existing coronary heart disease, renal disease, diabetes, ICU admission, oxygen therapy, and higher respiratory rates (p < 0.001 for each). Compared to Caucasians, Asians, Blacks, and Hispanics had almost 2-4 times higher risk of death. Further, patients from LIC, LMIC, UMIC versus. HIC had 2-3 times increased risk of death. Conclusions: The LIC, LMIC, and UMIC's have sparse data on COVID-19. We provide robust evidence on COVID-19 outcomes in these countries. This study can help guide future health care planning for the pandemic globally.

Full Text

Duke Authors

Cited Authors

  • Prabhakaran, D; Singh, K; Kondal, D; Raspail, L; Mohan, B; Kato, T; Sarrafzadegan, N; Talukder, SH; Akter, S; Amin, MR; Goma, F; Gomez-Mesa, J; Ntusi, N; Inofomoh, F; Deora, S; Philippov, E; Svarovskaya, A; Konradi, A; Puentes, A; Ogah, OS; Stanetic, B; Issa, A; Thienemann, F; Juzar, D; Zaidel, E; Sheikh, S; Ojji, D; Lam, CSP; Ge, J; Banerjee, A; Newby, LK; Ribeiro, ALP; Gidding, S; Pinto, F; Perel, P; Sliwa, K; WHF COVID-19 Study Collaborators,

Published Date

  • 2022

Published In

Volume / Issue

  • 17 / 1

Start / End Page

  • 40 -

PubMed ID

  • 35837356

Pubmed Central ID

  • PMC9205371

Electronic International Standard Serial Number (EISSN)

  • 2211-8179

Digital Object Identifier (DOI)

  • 10.5334/gh.1128


  • eng

Conference Location

  • England