The relationship between coronary artery disease and clinical outcomes in COVID-19: a single-center retrospective analysis

Introduction Recent studies have reported evidence that coronavirus disease 2019 (COVID-19) has disproportionately affected patients with underlying comorbidities Our study aims to evaluate the impact of both cardiac and noncardiac comorbidities on a high-risk population with COVID-19 infection and coronary artery disease (CAD) compared to those without CAD Methods This is a retrospective study of patients who tested COVID-19 positive via reverse transcriptase-PCR (RT-PCR) assay We compared the characteristics and outcomes of patients with and without CAD Population demographics, comorbidities and clinical outcomes were collected and analyzed Multivariate logistic regression analysis was used to identify factors associated with inpatient mortality Results A final sample population of 355 patients was identified, and 78 of which had a known diagnosis of coronary artery disease Our study population had a higher proportion of females, and those with CAD were significantly older The rates of cardiovascular risk factors including hypertension, diabetes mellitus and chronic kidney disease, as well as heart failure and chronic obstructive pulmonary disease were significantly higher in the CAD population Lactate dehydrogenase was the only inflammatory marker significantly lower in the CAD group, while troponin and brain natriuretic peptide were significantly higher in this population Patients with CAD also had significantly higher inpatient mortality (31% vs 20%, P = 0 046) and need for renal replacement therapy (33% vs 11%, P < 0 0001) compared to the non-CAD group However, only age [odds ratio 1 041 (1 017–1 066), P = 0 001] was significantly associated with mortality in the overall population after adjusting for demographics and comorbidities, while the presence of CAD was not independently associated with mortality Conclusion Patients with CAD and COVID-19 have higher rates of comorbidities, inpatient mortality and need for renal replacement therapy compared to their non-CAD counterparts However, CAD in itself was not associated with mortality after adjusting for other covariates, suggesting that other factors may play a larger role in the increased mortality and poor outcomes in these patients Received 13 June 2020 Accepted 1 July 2020 Supplemental Digital Content is available for this article Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website, www coronary-artery com Correspondence to Eric Peterson, DO, Einstein Medical Center, 5501 Old York Road, Philadelphia, PA 19141, USA, Tel: +215 456 6500;e-mail: PeteEric@einstein edu Copyright © 2020 Wolters Kluwer Health, Inc All rights reserved