Previous Heart Disease, a Determining Factor in Evolution of COVID-19 Patients 

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Previous Heart Disease, a Determining Factor in Evolution of COVID-19 Patients 

Patients with heart diseases are at increased risk of complications and mortality from COVID-19, according to an analysis of nearly 3,000 patients included in the registry HOPE COVID-19 (Health Outcome Predictive Evaluation for COVID 19) and published in the ‘Cardiology Journal’.

The database has become one of the largest registries of coronavirus patients internationally. In total, information was collected on 8,168 patients from 48 hospitals in 9 countries. The registry is an invaluable source of information on COVID-19, the profile of the most serious patients, and their management.

The Results

The analysis now published is based on data from 2,798 patients from 35 hospital centers in 7 countries, including Spain; with an average age of 67 years and 59.5 percent of men. The data reveal that 24 percent of them (682) had a previous coronary disease; a factor that was associated with greater use of respiratory and circulatory support and a greater proportion of events in the hospital such as heart or kidney failure, respiratory failure, sepsis or bleeding.

Also, patients with cardiac pathologies before COVID-19 infection had a crude risk of mortality that was 24 percent higher than the rest of the sample (39.7% vs. 15.5%). The registry data also reveal that these patients more frequently received treatment with corticosteroids (28.9% vs. 20.4% and antibiotics; but less with hydroxychloroquine, antivirals, or tocilizumab.

Patients with cardiac pathologies before COVID-19 infection had a crude risk of mortality 24 percent higher than the rest of the sample

Influence of Sodium Disorders

Researchers from the HOPE COVID-19 registry have also analyzed in another independent subanalysis the influence of sodium disorders at the time of hospital admission to observe the influence on the appearance of complications and mortality from COVID-19.

The data correspond to 4,664 patients (58% of them men) with a mean age of 66 years old and who were admitted last year. Sodium disorders are a known factor of hospital morbidity and mortality, due to the role that sodium plays in the balance of water in the body and the effect of plasma on the cells; which usually represents a poor prognostic factor in numerous pathologies.

According to the analysis, 20.5 percent of the patients had hyponatremia at the time of admission and 3.7 percent had hypernatremia. Both factors negatively influenced the risk of suffering sepsis and mortality associated with COVID-19 pneumonia.

The Way Forward

The HOPE COVID-19 study has been producing valuable clinical information for several months regarding numerous clinical factors that may influence the evolution and therapeutic approach of patients admitted with coronavirus infection.

What has become clear is that such data is invaluable, as is the need for more front line health workers to deal with such a pandemic. More effort needs to be made by healthcare facilities and physician recruiter firms to mobilize and optimize health workers not currently active in the field.

Through greater insights provided by data such as that mentioned above, and recruiting the necessary manpower to help implement the resulting recommendations, further progress can be made in combatting this global pandemic.

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