Association Between Previous Stroke and Severe COVID-19: A Retrospective Cohort Study and an Overall Review of Meta-Analysis

Analyzing the Outcomes of COVID-19 Infection on Patients With Comorbidities: Insights From Hospital-Based Study

Introduction COVID-19 exhibits a broad spectrum of clinical manifestations, ranging from asymptomatic or mild cases to severe respiratory distress and, in some instances, fatal outcomes. The pre-existing inflammatory state in the patient prior to exposure to COVID-19, which could be because of any etiology or comorbidity, has been associated with prolonged morbidity, and adverse outcomes like increased mortality have been found. This study endeavors to investigate the principal risk factors linked to the morbidity and mortality of COVID-19, such as age, gender, and co-morbidities such as hypertension, diabetes mellitus, and others. Material and methods Patient demographic data like age, gender, and co-morbidities like diabetes mellitus, hypertension, respiratory illness, and coronary artery diseases, cerebrovascular accident was observed. The patient clinical profile, hematological, inflammatory markers at the time of admission, and outcome were noticed. Patients were divided into two groups - patients with comorbidity and those without comorbidity. Results In each cohort of COVID-19 patients, comprising those with and without comorbidities, there were 145 participants. The mean age of patients without comorbidities was found to be 49.97 years, whereas the mean age of those with comorbidities was 64.35 years. Within the comorbidity group, males formed the majority, accounting for 77.2% of the cohort; in the group without comorbidity also males predominated, representing 68.3% of the participants. Hypertension was the most common co-morbidity (89.7%), followed by diabetes mellitus (39.3%), and ischemic heart disease (8.3%). The multivariate logistic regression analysis for prediction of mortality showed hypothyroidism with odds ratio (OR) of 336.26 and confidence intervals (CI) (1.19-9477.13), ischemic heart disease with OR of 320.94 (CI 3.19-3237.4) and presence greater than two co-morbidities with OR of 42.14 (CI 1.34-1325.76). Cox regression analysis showed a statistically significant hazard ratio of 0.294 in patients with greater than two co-morbidities. Conclusion Hypothyroidism, ischemic heart disease, and the presence of multiple comorbid conditions were associated with the severity of COVID-19 illness and mortality.

Short- and long-term effects of the COVID-19 pandemic on patients with cardiovascular diseases: A mini-review

The COVID-19 pandemic had profound implications for patients with cardiovascular diseases (CVDs), both in the short- and long-term. In this article, we provide an overview of the effects of the pandemic on individuals with preexisting cardiovascular conditions. In the short term, the severe acute respiratory syndrome coronavirus 2 infection increased the risk of many cardiovascular events. Furthermore, the pandemic has disrupted health-care systems worldwide, leading to constraints in routine care, and limited access to specialized cardiovascular services and procedure. This has resulted in increased morbidity and mortality rates among patients with CVD (coronary artery disease, hypertrophic cardiomyopathy, heart failure (HF), heart transplant recipients, atrial fibrillation, atrial flutter, previous stroke, or previous peripheral artery disease). In the long term, the COVID-19 impact on patients with CVD extends beyond the acute phase of the disease. Studies have highlighted the development of long-term cardiovascular complications in COVID-19 survivors, such as acute coronary syndrome myocarditis, HF, stroke, venous thromboembolism, and arrhythmias, which may lead to a surge of new cases associated with CVD in the postpandemic era. Health-care systems must prioritize cardiovascular care, developing strategies to identify the patients at higher risk and provide the care to minimize the impact of the pandemic on patients with CVD.