Pre-existing cardiovascular disease, acute kidney injury, and cardiovascular outcomes in hospitalized blacks with COVID-19 infection.

• Type of Material: Article
• Authors: Obiora Egbuche, Morehouse School of Medicine Atlanta, GA 30310, USA.; Opeyemi Jegede, University of North Texas Health Science Center Fort-Worth, TX 76107, USA.; Temidayo Abe, Morehouse School of Medicine Atlanta, GA 30310, USA.; Bivek Wagle, Morehouse School of Medicine Atlanta, GA 30310, USA.; Ky Huynh, Morehouse School of Medicine Atlanta, GA 30310, USA.; Dolphurs Hayes, Morehouse School of Medicine Atlanta, GA 30310, USA.; Martin L Campbell, Morehouse School of Medicine Atlanta, GA 30310, USA.; Kenechukwu Mezue, Massachusetts General Hospital, Harvard Medical School Boston, MA 02114, USA.; Pradhum Ram, Emory University; Shirley I Nwokike, Medical College of Georgia Augusta; Rupak Desai, Atlanta VA Medical Center Decatur; Valery Effoe, Morehouse School of Medicine Atlanta, GA 30310, USA.; Jacques Kpodonu, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA 02215, USA.; Jayne Morgan, Piedmont Healthcare, Inc. Atlanta, GA 30309, USA.; Elizabeth Ofili, Morehouse School of Medicine Atlanta, GA 30310, USA.; Anekwe Onwuanyi, Morehouse School of Medicine Atlanta, GA 30310, USA.; Melvin R Echols, Morehouse School of Medicine Atlanta, GA 30310, USA.
• Language: English
• Date: 2021
• Publisher: AJCD
• Publication Version: Final Published Version
• Copyright Statement: AJCD © 2021
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Title of Journal or Parent Work: Am J Cardiovasc Dis
• Volume: 11
• Issue: 2
• Start Page: 212
• End Page: 221
• Keywords: blacks; Pre-existing CVD; mortality; acute kidney injury; COVID-19
• Research Categories: Biology, Biostatistics; Health Sciences, Medicine and Surgery; Health Sciences, Epidemiology

Abstract

BACKGROUND: The Corona Virus 19 (COVID-19) infection is associated with worse outcomes in blacks, although the mechanisms are unclear. We sought to determine the significance of black race, pre-existing cardiovascular disease (pCVD), and acute kidney injury (AKI) on cardiopulmonary outcomes and in-hospital mortality of COVID-19 patients. METHODS: We conducted a retrospective cohort study of blacks with/without pCVD and with/without in-hospital AKI, hospitalized within Grady Memorial Hospital in Georgia between February and July 2020, who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on qualitative polymerase-chain-reaction assay. The primary outcome was a composite of in-hospital cardiac events. RESULTS: Of the 293 patients hospitalized with COVID-19 in this study, 71 were excluded from the primary analysis (for race/ethnicity other than black non-Hispanic). Of the 222 hospitalized COVID-19 patients included in our analyses, 41.4% were female, 78.8% had pCVD, and 30.6% developed AKI during the admission. In multivariable analyses, pCVD (OR 4.7, 95% CI 1.5-14.8, P=0.008) and AKI (OR 2.7, 95% CI 1.3-5.5, P=0.006) were associated with increased odds of in-hospital cardiac events. AKI was associated with increased odds of in-hospital mortality (OR 8.9, 95% CI 3.3-23.9, P<0.0001). The presence of AKI was associated with increased odds of ICU stay, mechanical ventilation, and acute respiratory distress syndrome (ARDS). CONCLUSION: pCVD and AKI were associated with higher risk of in-hospital cardiac events, and AKI was associated with a higher risk of in-hospital mortality in blacks.