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Model 1: Unadjusted associations between the exposures: (1) ‘ any’ cardiometabolic comorbidity, (2) Cardiometabolic multimorbidity count and (3) Ethnic group, and the primary outcomes: (1) ‘ any’ in-hospital cardiovascular/renal complication (2) In-hospital death and the secondary outcomes: each individual cardiovascular/renal complication. To investigate the relationship between cardiometabolic comorbidities, ethnicity and outcomes, we constructed three models. Accordingly, this study investigated the contribution of multiple cardiometabolic conditions and patient ethnicity, to the risk of cardiovascular/renal complications and death, in a large nationally representative sample of people hospitalised with COVID-19.ĭescriptive statistics are presented as number (%) and median (25th and 75th centiles) for categorical and continuous data, respectively, with differences between those with and without cardiovascular complications in these characteristics examined using standardised differences. In order to unpick the relative importance of the various factors contributing to adverse COVID-19 prognosis, large, well-phenotyped samples are required, with good coverage of these contributing factors. 11īecause people with COVID-19 often have a combination of different high-risk characteristics, it can be difficult to know which are the most important or whether some or all of the higher risk of COVID-19 complications in people who are non-Caucasian is explained by their cardiometabolic conditions. 9 10 Possible mechanisms linking COVID-19 with cardiovascular complications include the release of cytokines (‘cytokine storm’), dysregulation of the renin-angiotensin-aldosterone system and coagulation systems, and plaque rupture during the acute infection phase. 7 8 These insults can in turn lead to chronic cardiovascular damage or death, even in those without existing cardiovascular disease. 5 6 In addition to the baseline risk associated with cardiometabolic conditions, recent studies have shown that COVID-19 can cause acute cardiovascular injury including arrhythmias, cardiac arrest, myocardial infarction and heart failure. 4 These morbidities have been described as the primary chronic conditions that lead to worsening COVID-19 outcomes. Over 25% of patients hospitalised with COVID-19 have cardiometabolic conditions, including hypertension, obesity, diabetes and chronic cardiac disease.
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3 In particular, impaired cardiometabolic health has emerged as an important accelerator of severe COVID-19 disease. Individuals from non-Caucasian ethnic groups or with multiple chronic conditions have been found to be susceptible to severe COVID-19 disease, in-hospital cardiovascular complications and death. People who require hospital admission have the worse outcomes, with a mortality risk of 10%–26% in USA and the UK.
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After infection, the course of the disease (COVID-19) varies, ranging from asymptomatic mild infection to severe complications and death. As of April 2021, SARS-CoV-2 has infected over 140 million people and claimed over 3 million lives worldwide.