Outcomes and development of new cardiovascular conditions in patients with pre-existing cardiovascular disease after contracting COVID-19

Background: Since cardiovascular diseases are the leading cause of mortality worldwide, understanding the relationship between cardiovascular comorbidities and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is imperative for healthcare professionals when considering the care of those infected with coronavirus disease 2019 (COVID-19). This study aimed to assess the impact of cardiovascular comorbidities on patient outcomes in those who have tested positive for COVID-19. Methods: This study considered patients who were infected with COVID-19 in the 2020 calendar year. Electronic medical record data was retrospectively analyzed to assess how patients with and without cardiac comorbidities fared in terms of short-term mortality, duration and highest level of care required, and the development of new cardiac conditions. Crude and adjusted odds ratios (aORs) were run to assess the odds of death within 30 days with each comorbidity. aORs were also run to assess the odds of developing each cardiovascular disorder in those who survived beyond 30 days. Results: Among the 4,688 patients infected with COVID-19 within the study period, 54.3% of patients had at least one cardiac comorbidity and 3.1% of patients died overall. Our results highlighted that having cardiac comorbidities has been shown to result in worse disease outcomes including higher mortality rates (P<0.001), requiring higher levels of care (P<0.001), and longer hospital stays (P<0.001). They also revealed that the adjusted odds of mortality were significantly increased in patients with atrial fibrillation (P<0.001), ventricular arrhythmia (P=0.003), myocardial infarction (P<0.001), stroke (P=0.002), acute coronary artery disease (P=0.006), congestive heart failure (P<0.001), and deep vein thrombosis (P=0.005). Additionally, it was found that having at least one comorbidity increased the likelihood of developing a new cardiac diagnosis after COVID-19 infection (P<0.001) and that as the highest level of care required increased, the general likelihood of developing a new cardiovascular disorder also increased (P<0.001). Further, the adjusted odds of developing many of the cardiovascular disorders increased according to the highest level of care received. Conclusions: These results shed light on the increased risks of severe COVID-19 outcomes and give insight into the importance of tailored care in patients with cardiac comorbidities.