Background The relative association between cardiovascular (CV) risk factors, such as diabetes and hypertension, established CV disease (CVD), and susceptibility to CV complications or mortality in COVID-19 remains unclear. Methods We conducted a cohort study of consecutive adults hospitalised for severe COVID-19 between 1st March and 30th June 2020. Pre-existing CVD, CV risk factors and associations with mortality and CV complications were ascertained. Results Among 1721 patients (median age 71 years, 57% male), 349 (20.3%) had pre-existing CVD (CVD), 888 (51.6%) had CV risk factors without CVD (RF-CVD), 484 (28.1%) had neither. Patients with CVD were older with a higher burden of non-CV comorbidities. During follow-up, 438 (25.5%) patients died: 37% with CVD, 25.7% with RF-CVD and 16.5% with neither. CVD was independently associated with in-hospital mortality among patients < 70 years of age (adjusted HR 2.43 [95% CI 1.16–5.07]), but not in those ≥ 70 years (aHR 1.14 [95% CI 0.77–1.69]). RF-CVD were not independently associated with mortality in either age group (< 70 y aHR 1.21 [95% CI 0.72–2.01], ≥ 70 y aHR 1.07 [95% CI 0.76–1.52]). Most CV complications occurred in patients with CVD (66%) versus RF-CVD (17%) or neither (11%; p < 0.001). 213 [12.4%] patients developed venous thromboembolism (VTE). CVD was not an independent predictor of VTE. Conclusions In patients hospitalised with COVID-19, pre-existing established CVD appears to be a more important contributor to mortality than CV risk factors in the absence of CVD. CVD-related hazard may be mediated, in part, by new CV complications. Optimal care and vigilance for destabilised CVD are essential in this patient group. Trial registration n/a. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02137-9.
【저자키워드】 COVID-19, cardiovascular disease, diabetes, hypertension, cardiovascular risk factors, 【초록키워드】 Risk factors, Mortality, severe COVID-19, susceptibility, Comorbidities, risk factor, Venous Thromboembolism, cohort study, male, Patient, age, Follow-up, disease, Care, in-hospital mortality, association, VTE, CVD, Older, supplementary material, median age, MOST, hospitalised, independent, Result, occurred, conducted, adjusted, appear, absence, diabete, CV complication, CV complications, with COVID-19, 【제목키워드】 Mortality, cardiovascular risk factor,