tetano
Editor, Senior Moderator
Am J Cardiovasc Dis
. 2021 Apr 15;11(2):212-221.
eCollection 2021.
Pre-existing cardiovascular disease, acute kidney injury, and cardiovascular outcomes in hospitalized blacks with COVID-19 infection
Obiora Egbuche[SUP] 1 [/SUP], Opeyemi Jegede[SUP] 2 [/SUP], Temidayo Abe[SUP] 3 [/SUP], Bivek Wagle[SUP] 3 [/SUP], Ky Huynh[SUP] 3 [/SUP], Dolphurs Hayes[SUP] 3 [/SUP], Martin Luther Campbell[SUP] 3 [/SUP], Kenechukwu Mezue[SUP] 4 [/SUP], Pradhum Ram[SUP] 5 [/SUP], Shirley I Nwokike[SUP] 6 [/SUP], Rupak Desai[SUP] 7 [/SUP], Valery Effoe[SUP] 1 [/SUP], Jacques Kpodonu[SUP] 8 [/SUP], Jayne Morgan[SUP] 9 [/SUP], Elizabeth Ofili[SUP] 1 [/SUP], Anekwe Onwuanyi[SUP] 1 [/SUP], Melvin R Echols[SUP] 1 [/SUP]
Affiliations
Abstract
Background: The Corona Virus 19 (COVID-19) infection is associated with worse outcomes in blacks, although the mechanisms are unclear. We sought to determine the significance of black race, pre-existing cardiovascular disease (pCVD), and acute kidney injury (AKI) on cardiopulmonary outcomes and in-hospital mortality of COVID-19 patients.
Methods: We conducted a retrospective cohort study of blacks with/without pCVD and with/without in-hospital AKI, hospitalized within Grady Memorial Hospital in Georgia between February and July 2020, who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on qualitative polymerase-chain-reaction assay. The primary outcome was a composite of in-hospital cardiac events.
Results: Of the 293 patients hospitalized with COVID-19 in this study, 71 were excluded from the primary analysis (for race/ethnicity other than black non-Hispanic). Of the 222 hospitalized COVID-19 patients included in our analyses, 41.4% were female, 78.8% had pCVD, and 30.6% developed AKI during the admission. In multivariable analyses, pCVD (OR 4.7, 95% CI 1.5-14.8, P=0.008) and AKI (OR 2.7, 95% CI 1.3-5.5, P=0.006) were associated with increased odds of in-hospital cardiac events. AKI was associated with increased odds of in-hospital mortality (OR 8.9, 95% CI 3.3-23.9, P<0.0001). The presence of AKI was associated with increased odds of ICU stay, mechanical ventilation, and acute respiratory distress syndrome (ARDS).
Conclusion: pCVD and AKI were associated with higher risk of in-hospital cardiac events, and AKI was associated with a higher risk of in-hospital mortality in blacks.
Keywords: COVID-19; Pre-existing CVD; acute kidney injury; blacks; mortality.
. 2021 Apr 15;11(2):212-221.
eCollection 2021.
Pre-existing cardiovascular disease, acute kidney injury, and cardiovascular outcomes in hospitalized blacks with COVID-19 infection
Obiora Egbuche[SUP] 1 [/SUP], Opeyemi Jegede[SUP] 2 [/SUP], Temidayo Abe[SUP] 3 [/SUP], Bivek Wagle[SUP] 3 [/SUP], Ky Huynh[SUP] 3 [/SUP], Dolphurs Hayes[SUP] 3 [/SUP], Martin Luther Campbell[SUP] 3 [/SUP], Kenechukwu Mezue[SUP] 4 [/SUP], Pradhum Ram[SUP] 5 [/SUP], Shirley I Nwokike[SUP] 6 [/SUP], Rupak Desai[SUP] 7 [/SUP], Valery Effoe[SUP] 1 [/SUP], Jacques Kpodonu[SUP] 8 [/SUP], Jayne Morgan[SUP] 9 [/SUP], Elizabeth Ofili[SUP] 1 [/SUP], Anekwe Onwuanyi[SUP] 1 [/SUP], Melvin R Echols[SUP] 1 [/SUP]
Affiliations
- PMID: 34084656
- PMCID: PMC8166582
Abstract
Background: The Corona Virus 19 (COVID-19) infection is associated with worse outcomes in blacks, although the mechanisms are unclear. We sought to determine the significance of black race, pre-existing cardiovascular disease (pCVD), and acute kidney injury (AKI) on cardiopulmonary outcomes and in-hospital mortality of COVID-19 patients.
Methods: We conducted a retrospective cohort study of blacks with/without pCVD and with/without in-hospital AKI, hospitalized within Grady Memorial Hospital in Georgia between February and July 2020, who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on qualitative polymerase-chain-reaction assay. The primary outcome was a composite of in-hospital cardiac events.
Results: Of the 293 patients hospitalized with COVID-19 in this study, 71 were excluded from the primary analysis (for race/ethnicity other than black non-Hispanic). Of the 222 hospitalized COVID-19 patients included in our analyses, 41.4% were female, 78.8% had pCVD, and 30.6% developed AKI during the admission. In multivariable analyses, pCVD (OR 4.7, 95% CI 1.5-14.8, P=0.008) and AKI (OR 2.7, 95% CI 1.3-5.5, P=0.006) were associated with increased odds of in-hospital cardiac events. AKI was associated with increased odds of in-hospital mortality (OR 8.9, 95% CI 3.3-23.9, P<0.0001). The presence of AKI was associated with increased odds of ICU stay, mechanical ventilation, and acute respiratory distress syndrome (ARDS).
Conclusion: pCVD and AKI were associated with higher risk of in-hospital cardiac events, and AKI was associated with a higher risk of in-hospital mortality in blacks.
Keywords: COVID-19; Pre-existing CVD; acute kidney injury; blacks; mortality.