The effect of vascular risk factor burden on the severity of COVID-19 illness, a retrospective cohort study
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RESEARCH
Open Access
The effect of vascular risk factor burden on the severity of COVID-19 illness, a retrospective cohort study Houwei Du1,2*† , Xiaobin Pan3†, Nan Liu1,4†, Junnian Chen5, Xiaoling Chen6, David J. Werring7, Gareth Ambler8, Xiaoqing Li9, Ronghua Chen1,2, Yixian Zhang4, Huayao Huang4, Feifei Lin1, Pincang Xia9, Chao Chen10, Zhenyang Zheng1,2, Sangru Wu1, Hanhan Lei1, Lei Gao11, Mingxu Huang12, Kexu Lin12, Xiaoping Xu13, Yukun Luo14, Ziwen Zhao14, Chen Li15, Hailong Lin16, Yu Lin17, Zhenghui Huang18, Rongxiang Cao18, Limin Chen18 and On behalf of the Fujian Medical Team Support Wuhan for COVID-19
Abstract Background: Patients with cardiovascular comorbidities are at high risk of poor outcome from COVID-19. However, how the burden (number) of vascular risk factors influences the risk of severe COVID-19 disease remains unresolved. Our aim was to investigate the association of severe COVID-19 illness with vascular risk factor burden. Methods: We included 164 (61.8 ± 13.6 years) patients with COVID-19 in this retrospective study. We compared the difference in clinical characteristics, laboratory findings and chest computed tomography (CT) findings between patients with severe and non-severe COVID-19 illness. We evaluated the association between the number of vascular risk factors and the development of severe COVID-19 disease, using a Cox regression model. Results: Sixteen (9.8%) patients had no vascular risk factors; 38 (23.2%) had 1; 58 (35.4%) had 2; 34 (20.7%) had 3; and 18 (10.9%) had ≥4 risk factors. Twenty-nine patients (17.7%) experienced severe COVID-19 disease with a median (14 [7–27] days) duration between onset to developing severe COVID-19 disease, an event rate of 4.47 per 1000-patient days (95%CI 3.10–6.43). Kaplan-Meier curves showed a gradual increase in the risk of severe COVID-19 illness (log-rank P < 0.001) stratified by the number of vascular risk factors. After adjustment for age, sex, and comorbidities as potential confounders, vascular risk factor burden remained associated with an increasing risk of severe COVID-19 illness. Conclusions: Patients with increasing vascular risk factor burden have an increasing risk of severe COVID-19 disease, and this population might benefit from specific COVID-19 prevention (e.g., self-isolation) and early hospital treatment measures. Keywords: Vascular risk factor, Coronavirus disease 2019, Prognosis
* Correspondence: [email protected]; [email protected] † Houwei Du, Xiaobin Pan and Nan Liu contributed equally to this work. 1 Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou 350001, China 2 Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as
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