Smoking, diabetes and obesity – not pre-existing heart disease – bigger risk of COVID-19 death

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In a study from Michigan Medicine, scientists found that risk factors for heart disease, such as age, smoking and diabetes – not pre-existing heart disease – are the main contributors to death and poor outcomes for critically ill COVID-19 patients.

They analyzed outcomes for more than 5,100 patients admitted to intensive care units at 68 centers across the United States with severe COVID between March and June of 2020.

Of those patients, 1,174 had either preexisting coronary artery disease, congestive heart failure, or atrial fibrillation.

The team found that patients with cardiovascular disease had close to a 30% higher mortality rate than critically ill COVID patients without the preexisting condition.

However, when adjusting for risk factors – including age, sex, race, smoking, and others – that relationship was no longer strong.

A total of 34.6% of patients died within 28 days and nearly 18% suffered a cardiovascular event, such as cardiac arrest or myocarditis.

Researchers say the association between such events and death did not differ between patients with and without preexisting heart disease.

Cardiovascular disease is a common condition among patients who suffer from severe COVID illness, given its prevalence among older adults and associated chronic inflammation.

In the study, age, obesity, and diabetes were much stronger predictors of death due to COVID.

Regardless of whether a patient had pre-existing heart disease, the researchers found the presence of myocardial injury was associated with heart disease events and death.

Heart injury was common among patients in the ICU, occurring in nearly half of patients who had heightened levels of troponin, a protein released when the heart muscle is damaged.

Patients with the highest troponin measurements were nearly three times more likely to die than those without myocardial injury.

The team says the findings should not minimize the fact that patients with cardiovascular disease are still at risk for death due to COVID-19, as they have a high burden of risk factors for the disease, such as diabetes, hypertension and smoking.

If you care about COVID, please read studies that people over 50 years old may get shingles after COVID-19, and scientists find antibodies that block all the COVID-19 variants.

For more information about COVID, please see recent studies that your genes and blood type may help predict your risk of severe COVID-19, and results showing common anti-inflammatory drugs may prevent COVID-19 deaths.

The study was conducted by Salim Hayek et al and published in Circulation: Cardiovascular Quality and Outcomes.

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