Predictors of cardiovacular risk as prognostic factors of adverse course and outcomes of COVID-19 in young and middle age adults

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Abstract

The prevalence of cardiovascular diseases and their predictors is a significant global public health problem. Therefore, the study about the relationship between concomitant cardiovascular diseases, their risk factors and adverse outcomes of COVID-19 is more relevant than ever.

The aim: to study the influence of cardiovascular risk predictors on the course of a novel coronavirus infection in young and middle-aged adults.

Material and methods. A retrospective analysis of 337 case histories of young and middle-aged adults (40,0±13,3 years) was carried out. Depending on the severity of the course of coronavirus infection, the subjects were divided into 4 groups: mild, moderate, severe, and the dead. Primary medical information was collected. To develop a statistical model for identifying the likelihood of a severe course and death of a novel coronavirus infection, a logistic regression analysis was used with multivariate model, followed by an assessment of the diagnostic value of the prognostic model using the ROC curve and determining the area under it.

Results. It was shown that a more severe course of COVID-19 and death were observed in middle-aged individuals with increased BMI, pulse rate and blood pressure at admission. Higher glucose and cholesterol values were associated with increased severity of COVID-19. The presence of cardiovascular diseases, hypertension, and a history of diabetes mellitus prevailed in the group of the deceased and, accordingly, can be considered as predictors of an unfavorable course. Based on the identified risk factors, a mathematical model was developed for predicting a severe course and the development of a lethal outcome against the background of a novel coronavirus infection.

Conclusion. Timely drug correction of blood pressure levels, maintaining the target level of glycemia, triglycerids, low-density lipoproteins, weight loss should be one of the main goals for the timely prevention of adverse outcomes of COVID-19. Moreover, if a patient with COVID-19 is at risk of severe course and death, the therapy of cardiovascular risk factors should be immediately prescribed and/or, if necessary, adjusted.

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About the authors

Ekaterina S. Bratilova

S.M. Kirov Military Medical Academy of the Ministry of Defence of the Russian Federation

Author for correspondence.
Email: guanilatciclaza@mail.ru
ORCID iD: 0000-0003-2153-2121
SPIN-code: 4647-2564

cardiologist at the Clinic of faculty therapy

Russian Federation, 194044, Saint Petersburg, 6 Akademika Lebedeva Str.

Vasily A. Kachnov

S.M. Kirov Military Medical Academy of the Ministry of Defence of the Russian Federation

Email: kvasa@mail.ru
ORCID iD: 0000-0002-6601-5366
SPIN-code: 2084-0290

MD, lecturer at the Department of faculty therapy

Russian Federation, 194044, Saint Petersburg, 6 Akademika Lebedeva Str.

Vadim V. Tyrenko

S.M. Kirov Military Medical Academy of the Ministry of Defence of the Russian Federation

Email: vadim_tyrenko@mail.ru
ORCID iD: 0000-0002-0470-1109
SPIN-code: 3022-5038

MD, professor, head of the Department of faculty therapy

Russian Federation, 194044, Saint Petersburg, 6 Akademika Lebedeva Str.

Oleg V. Afonaskov

P.V. Mandryka Central Military Clinical Hospital of the Ministry of Defence of the Russian Federation

Email: afonaskov@yandex.ru
ORCID iD: 0000-0003-4547-5459
SPIN-code: 6872-3878

MD, chief therapist

Russian Federation, Moscow

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