Hassan Brim, Muhammad Ahmad Imran, Wardah Bajwa, Mrinalini Deverapali, Anas Brim, Rumaisa Rashid, Mudasir Rashid, Aurmin Amirmokri, Ali Ramadan, Neda Dezfuli, Sabtain Saroya, Soha Mohammed, Kevin Boluyt, Shahnoza Dusmatova, Jaide Cotton, Keyshawn Davis, Matthew Deleary, Noah Wheaton, Degrick Cheatham, Armando Ugarte, Yusuf Ashktorab, Shweta Dixit, Zaki Sherif, Adeyinka Laiyemo, Farshad Aduli, Angesom Kibreab, John M Carethers, Gholamreza Oskrochi, Hassan Ashktorab
CVD substantially worsens COVID-19 outcomes, with AAs disproportionately affected. These results highlight the need for targeted, race-specific strategies to improve management of COVID-19 in patients with cardiovascular comorbidities.
BACKGROUND: Cardiovascular disease (CVD) is a significant comorbidity influencing COVID-19 outcome. This study assesses its impact on hospitalized COVID-19 patients at Howard University Hospital.
METHODS: A retrospective analysis was performed on a cohort of 1,580 hospitalized predominantly African American (AA) COVID-19 patients that were classified as CVD (n = 428, 27%) and non-CVD (n = 1,152, 73%) and further stratified by race to assess demographic, clinical, and laboratory differences.
RESULTS: CVD patients exhibited higher rates of hypertension (86% vs. 49%), diabetes (47% vs. 25%), and acute kidney injury (37% vs. 21%) compared to non-CVD patients (p < 0.01). ICU transfers (24% vs. 16%) and mortality (21% vs. 10%) were also statistically significant. CVD patients showed higher troponin, pro-BNP, and inflammatory markers, but lower substance use (13% vs. 23%). The study also highlights racial disparities in CVD outcomes. African Americans and Hispanics with CVD had higher ICU transfers (23% and 38%, p < 0.05), whereas mortality was significant in AA but not in other races. Elevated sodium, potassium, creatinine, and cardiac biomarkers were significantly more common in AA and Whites with CVD had higher nursing home residency (15% and 27%, p < 0.05). Race-based GI comparisons showed few significant differences. AA with CVD had borderline higher GI symptoms (59% vs. 53%, p = 0.07) and elevated ALT peaks (61% vs. 25%, p < 0.05). Whites showed higher ALP peaks (21% vs. 4%, p < 0.05)with no significant changes in Hispanics.
CONCLUSION: CVD substantially worsens COVID-19 outcomes, with AAs disproportionately affected. These results highlight the need for targeted, race-specific strategies to improve management of COVID-19 in patients with cardiovascular comorbidities.