Cardiovascular Risk Factors and the Severity of COVID-19 Disease

Imane Motaib; Saad Zbiri; Saloua Elamari; Amal Haoudar; Asma Chadli; Chafik El Kettani

doi:10.7759/cureus.15486

Cardiovascular Risk Factors and the Severity of COVID-19 Disease

Cureus. 2021 Jun 7;13(6):e15486. doi: 10.7759/cureus.15486. eCollection 2021 Jun.

Authors

Imane Motaib¹, Saad Zbiri², Saloua Elamari³, Amal Haoudar⁴, Asma Chadli³, Chafik El Kettani⁴

Affiliations

¹ Endocrinology, Diabetes, and Metabolism, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR.
² Epidemiology and Public Health, Laboratory of Public Health, Health Economics, and Health Management, International School of Public Health, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR.
³ Endocrinology, Diabetology, Metabolic Disease, and Nutrition, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR.
⁴ Anesthesia and Critical Care, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR.

Abstract

Background and objective Several cardiovascular risk factors have emerged as important determinants of severe illness and death among coronavirus disease 2019 (COVID-19) patients. However, the full impact of these cardiovascular risk factors is still under investigation. This study aimed to investigate the association between patients' level of cardiovascular risk and the severity of COVID-19. Materials and methods This observational study included all adult patients with COVID-19 hospitalized at Sheikh Khalifa Ibn Zaid International University Hospital from March 20 to May 10, 2020. The cardiovascular risk level was assessed by the doctor responsible for each patient based on the 2019 European Society of Cardiology (ESC), the European Atherosclerosis Society (EAS), and the European Association for the Study of Diabetes (EASD) guidelines. We examined the association between the patients' level of cardiovascular risk and their severity of COVID-19 disease by using a logistic regression model. Results Among 133 patients with confirmed COVID-19, 46.6% had a low cardiovascular risk level, 19.5% had a moderate risk level, 15.8% had a high risk level, and 18.1% was found to have a very high risk level. Patients with different cardiovascular risk levels had significantly different rates of complications including secondary infection (p-value: <0.001), acute respiratory distress syndrome (ARDS) (p-value = 0.017), intensive care unit (ICU) admission (p-value: <0.001), and death (p-value: <0.001). A patient's very high cardiovascular risk level versus low, moderate, or high cardiovascular risk level was independently associated with ICU admission [OR = 6.42, 95% CI: (1.45-28.30)]. Conclusion Based on our findings, an increased level of cardiovascular risk among patients was strongly associated with the severity of COVID-19. This study also highlights the need for assessing cardiovascular risk factors in all patients with COVID-19.

Keywords: covid 19; sar-cov 2 infection; severity markers; traditional cardiovascular risk factors.