Associations between pre-existing comorbidities and in-hospital cardiovascular events and mortality among COVID-19 patients in Bangladesh: a secondary analysis of a prospective cohort study
Objective To identify the associations of in-hospital cardiovascular events and mortality with pre-existing comorbidities and cardiovascular disease (CVD) risk factors among COVID-19 patients in Bangladesh without vaccine availability.Design A secondary analysis of a prospective multicountry study.S...
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BMJ Publishing Group
2024-08-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/8/e083982.full |
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| author | Tippawan Liabsuetrakul Farzana Islam Abdur Rahim Abdul Wadud Chowdhury Kazi Fayzus Salahin Md. Robed Amin Shahin Akter Shamim Talukder Quazi Monirul Islam |
| author_facet | Tippawan Liabsuetrakul Farzana Islam Abdur Rahim Abdul Wadud Chowdhury Kazi Fayzus Salahin Md. Robed Amin Shahin Akter Shamim Talukder Quazi Monirul Islam |
| author_sort | Tippawan Liabsuetrakul |
| collection | DOAJ |
| description | Objective To identify the associations of in-hospital cardiovascular events and mortality with pre-existing comorbidities and cardiovascular disease (CVD) risk factors among COVID-19 patients in Bangladesh without vaccine availability.Design A secondary analysis of a prospective multicountry study.Setting Three COVID-19-designated hospitals in Bangladesh.Participants Adult patients aged ≥18 years with PCR-positive COVID-19 admitted between 10 October 2020 and 31 July 2021 at participating hospitals.Outcome measures In-hospital cardiovascular events and mortality.Main exposures Pre-existing comorbidities and cardiovascular risk factors.Results In 897 COVID-19 patients, 18.7% developed cardiovascular events and 12.6% died. After adjusting for clinical information and treatment, patients with two comorbidities (excluding CVD risk factors) were significantly associated with cardiovascular events (adjusted (adj.) OR 2.47, 95% CI 1.24 to 4.90). Patients with a higher heart rate at admission (adj. OR 1.03, 95% CI 1.01 to 1.04) and those who were receiving intravenous fluids (adj. OR 2.13, 95% CI 1.23 to 3.70) or antibiotics (adj. OR 4.54, 95% CI 1.47 to 14.01) had significantly higher odds of cardiovascular events. The odds of cardiovascular events were lower in those receiving antiviral medications (adj. OR 0.31, 95% CI 0.18 to 0.53). There were no interactions between comorbidities and other covariates in the models. Comorbidities and cardiovascular risk factors were not significantly associated with 30-day mortality in the Cox regression models after adjusting with clinical information and treatment. The mortality within 30 days of admission was significantly higher in patients receiving corticosteroids (adj. HR 2.82, 95% CI 1.48 to 5.38) and lower in those receiving antiviral treatment (adj. HR 0.53, 95% CI 0.34 to 0.81). Those having cardiovascular events significantly increased mortality hazard.Conclusions Clinical factors and treatment affected in-hospital cardiovascular events, which subsequently increased the risk of mortality within 30 days for COVID-19 patients. COVID-19 patients regardless of CVD risk factors and comorbidities require close monitoring for cardiovascular events. |
| format | Article |
| id | doaj-art-1bf3828480c345cd97be4bef03fd285f |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-1bf3828480c345cd97be4bef03fd285f2025-08-20T01:58:23ZengBMJ Publishing GroupBMJ Open2044-60552024-08-0114810.1136/bmjopen-2024-083982Associations between pre-existing comorbidities and in-hospital cardiovascular events and mortality among COVID-19 patients in Bangladesh: a secondary analysis of a prospective cohort studyTippawan Liabsuetrakul0Farzana Islam1Abdur Rahim2Abdul Wadud Chowdhury3Kazi Fayzus Salahin4Md. Robed Amin5Shahin Akter6Shamim Talukder7Quazi Monirul Islam8Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, ThailandEminence Associates for Social Development, Dhaka, BangladeshKuwait Bangladesh Friendship Government Hospital, Dhaka, BangladeshBangladesh Specialized Hospital, Dhaka, BangladeshEminence Associates for Social Development, Dhaka, BangladeshMedicine, Dhaka Medical College and Hospital, Dhaka, BangladeshEminence Associates for Social Development, Dhaka, BangladeshEminence Associates for Social Development, Dhaka, BangladeshDepartment of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, ThailandObjective To identify the associations of in-hospital cardiovascular events and mortality with pre-existing comorbidities and cardiovascular disease (CVD) risk factors among COVID-19 patients in Bangladesh without vaccine availability.Design A secondary analysis of a prospective multicountry study.Setting Three COVID-19-designated hospitals in Bangladesh.Participants Adult patients aged ≥18 years with PCR-positive COVID-19 admitted between 10 October 2020 and 31 July 2021 at participating hospitals.Outcome measures In-hospital cardiovascular events and mortality.Main exposures Pre-existing comorbidities and cardiovascular risk factors.Results In 897 COVID-19 patients, 18.7% developed cardiovascular events and 12.6% died. After adjusting for clinical information and treatment, patients with two comorbidities (excluding CVD risk factors) were significantly associated with cardiovascular events (adjusted (adj.) OR 2.47, 95% CI 1.24 to 4.90). Patients with a higher heart rate at admission (adj. OR 1.03, 95% CI 1.01 to 1.04) and those who were receiving intravenous fluids (adj. OR 2.13, 95% CI 1.23 to 3.70) or antibiotics (adj. OR 4.54, 95% CI 1.47 to 14.01) had significantly higher odds of cardiovascular events. The odds of cardiovascular events were lower in those receiving antiviral medications (adj. OR 0.31, 95% CI 0.18 to 0.53). There were no interactions between comorbidities and other covariates in the models. Comorbidities and cardiovascular risk factors were not significantly associated with 30-day mortality in the Cox regression models after adjusting with clinical information and treatment. The mortality within 30 days of admission was significantly higher in patients receiving corticosteroids (adj. HR 2.82, 95% CI 1.48 to 5.38) and lower in those receiving antiviral treatment (adj. HR 0.53, 95% CI 0.34 to 0.81). Those having cardiovascular events significantly increased mortality hazard.Conclusions Clinical factors and treatment affected in-hospital cardiovascular events, which subsequently increased the risk of mortality within 30 days for COVID-19 patients. COVID-19 patients regardless of CVD risk factors and comorbidities require close monitoring for cardiovascular events.https://bmjopen.bmj.com/content/14/8/e083982.full |
| spellingShingle | Tippawan Liabsuetrakul Farzana Islam Abdur Rahim Abdul Wadud Chowdhury Kazi Fayzus Salahin Md. Robed Amin Shahin Akter Shamim Talukder Quazi Monirul Islam Associations between pre-existing comorbidities and in-hospital cardiovascular events and mortality among COVID-19 patients in Bangladesh: a secondary analysis of a prospective cohort study BMJ Open |
| title | Associations between pre-existing comorbidities and in-hospital cardiovascular events and mortality among COVID-19 patients in Bangladesh: a secondary analysis of a prospective cohort study |
| title_full | Associations between pre-existing comorbidities and in-hospital cardiovascular events and mortality among COVID-19 patients in Bangladesh: a secondary analysis of a prospective cohort study |
| title_fullStr | Associations between pre-existing comorbidities and in-hospital cardiovascular events and mortality among COVID-19 patients in Bangladesh: a secondary analysis of a prospective cohort study |
| title_full_unstemmed | Associations between pre-existing comorbidities and in-hospital cardiovascular events and mortality among COVID-19 patients in Bangladesh: a secondary analysis of a prospective cohort study |
| title_short | Associations between pre-existing comorbidities and in-hospital cardiovascular events and mortality among COVID-19 patients in Bangladesh: a secondary analysis of a prospective cohort study |
| title_sort | associations between pre existing comorbidities and in hospital cardiovascular events and mortality among covid 19 patients in bangladesh a secondary analysis of a prospective cohort study |
| url | https://bmjopen.bmj.com/content/14/8/e083982.full |
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