Obiora Egbuche1, Opeyemi Jegede2, Temidayo Abe3, Bivek Wagle3, Ky Huynh3, Dolphurs Hayes3, Martin Luther Campbell3, Kenechukwu Mezue4, Pradhum Ram5, Shirley I Nwokike6, Rupak Desai7, Valery Effoe1, Jacques Kpodonu8, Jayne Morgan9, Elizabeth Ofili1, Anekwe Onwuanyi1, Melvin R Echols1. 1. Division of Cardiovascular Disease, Morehouse School of Medicine Atlanta, GA 30310, USA. 2. Department of Biostatistics and Epidemiology, University of North Texas Health Science Center Fort-Worth, TX 76107, USA. 3. Department of Internal Medicine, Morehouse School of Medicine Atlanta, GA 30310, USA. 4. Division of Nuclear Cardiology, Massachusetts General Hospital, Harvard Medical School Boston, MA 02114, USA. 5. Division of Cardiovascular Disease, Emory University School of Medicine Atlanta, GA 30322, USA. 6. Department of Internal Medicine, Medical College of Georgia Augusta, GA 30912, USA. 7. Division of Cardiovascular Disease, Atlanta VA Medical Center Decatur, GA 30033, USA. 8. Division of Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA 02215, USA. 9. Division of Quality and Safety, Piedmont Healthcare, Inc. Atlanta, GA 30309, USA.
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. AJCD
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-19patients. 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-19patients 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. AJCD
Authors: Han Zhu; June-Wha Rhee; Paul Cheng; Sarah Waliany; Amy Chang; Ronald M Witteles; Holden Maecker; Mark M Davis; Patricia K Nguyen; Sean M Wu Journal: Curr Cardiol Rep Date: 2020-04-21 Impact factor: 2.931
Authors: Frederick G P Welt; Pinak B Shah; Herbert D Aronow; Anna E Bortnick; Timothy D Henry; Matthew W Sherwood; Michael N Young; Laura J Davidson; Sabeeda Kadavath; Ehtisham Mahmud; Ajay J Kirtane Journal: J Am Coll Cardiol Date: 2020-03-19 Impact factor: 24.094
Authors: Elissa Driggin; Mahesh V Madhavan; Behnood Bikdeli; Taylor Chuich; Justin Laracy; Giuseppe Biondi-Zoccai; Tyler S Brown; Caroline Der Nigoghossian; David A Zidar; Jennifer Haythe; Daniel Brodie; Joshua A Beckman; Ajay J Kirtane; Gregg W Stone; Harlan M Krumholz; Sahil A Parikh Journal: J Am Coll Cardiol Date: 2020-03-19 Impact factor: 24.094