Risk for in-hospital death increased with age >65, underlying cardiovascular disease, COPD, smoking
WEDNESDAY, May 6, 2020 (HealthDay News) — Age and underlying cardiovascular disease are associated with in-hospital mortality in COVID-19, according to a study published online May 1 in the New England Journal of Medicine.
Mandeep R. Mehra, M.D., from Harvard Medical School in Boston, and colleagues examined the correlation between cardiovascular disease and drug therapy with in-hospital death among hospitalized patients with COVID-19 in 169 hospitals in Asia, Europe, and North America.
Overall, 515 (5.8 percent) of the 8,910 patients with COVID-19 for whom discharge status was available died in the hospital and 8,395 survived to discharge. The researchers found that factors independently associated with an increased risk for in-hospital death included age >65 years (odds ratio [OR], 1.93; 95 percent confidence interval [CI], 1.60 to 2.41), coronary artery disease (OR, 2.70; 95 percent CI, 2.08 to 3.51), heart failure (OR, 2.48; 95 percent CI, 1.62 to 3.79), and cardiac arrhythmia (OR, 1.95; 95 percent CI, 1.33 to 2.86). Chronic obstructive pulmonary disease (OR, 2.96; 95 percent CI, 2.00 to 4.40) and current smoking (OR, 1.79; 95 percent CI, 1.29 to 2.47) were also associated with an increased risk for in-hospital death. The risk for in-hospital death was not increased in association with angiotensin-converting enzyme (ACE) inhibitor use (OR 0.33; 95 percent CI, 0.20 to 0.54) or with angiotensin-receptor blocker (ARB) use (OR, 1.23; 95 percent CI, 0.87 to 1.74).
“We were not able to confirm previous concerns regarding a potential harmful association of ACE inhibitors or ARBs with in-hospital mortality in this clinical context,” the authors write.
One author disclosed financial ties to Surgisphere; one author disclosed ties to the pharmaceutical, biotechnology, and medical device industries.
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