Clinical Characteristics, Outcomes, and Risk Factors of Disease Severity in Patients With COVID-19 and With a History of Cerebrovascular Disease in Wuhan, China: A Retrospective Study
Background and Purpose: Coronavirus disease 2019 (COVID-19) rapidly resulted in a pandemic. Information on patients with a history of cerebrovascular disease (CVD) infected with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is limited. This study investigated the clinical features and...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-01-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.706478/full |
| _version_ | 1798035927629561856 |
|---|---|
| author | Mengzhen Li Zehui He Jiecong Yang Qihua Guo Heng Weng Jielian Luo Baoying Gong Wanzhen Cui Banghan Ding Jianwen Guo Jianwen Guo |
| author_facet | Mengzhen Li Zehui He Jiecong Yang Qihua Guo Heng Weng Jielian Luo Baoying Gong Wanzhen Cui Banghan Ding Jianwen Guo Jianwen Guo |
| author_sort | Mengzhen Li |
| collection | DOAJ |
| description | Background and Purpose: Coronavirus disease 2019 (COVID-19) rapidly resulted in a pandemic. Information on patients with a history of cerebrovascular disease (CVD) infected with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is limited. This study investigated the clinical features and the risk factors of developing adverse outcomes in patients with COVID-19 and with previous CVD.Methods: This was a single-center retrospective clinical study including all the confirmed cases of COVID-19 at Wuhan Huoshenshan Hospital from February 4 to April 7, 2020. Differences in clinical characteristics were compared between patients with and without a history of CVD. The incidences of severe events comprising all-cause death, intensive care unit admission, shock, and mechanical ventilation usage during hospitalization in two groups were compared using propensity score matching analysis and multivariate logistic regression analyses. Besides, the risk factors of developing severe events in patients with COVID-19 who also have history of CVD were analyzed.Results: A total of 2,554 consecutive patients were included in our study, of whom 109 (4.27%) had a medical history of CVD. Patients with CVD tend to be older and with more comorbidities, including hypertension, diabetes, coronary heart disease, and chronic obstructive pulmonary disease. The levels of white blood cell, neutrophil, C-reactive protein, creatine kinase isoenzymes, and lactate dehydrogenase were higher, whereas the levels of lymphocyte and albumin were lower in the CVD group. Compared to those without CVD, patients with CVD were more likely to have severe events after age matching (12.8 vs. 5.7%, P = 0.012). After adjusting for the confounding effects of age, sex, smoking, and comorbidities, the odds ratio for developing severe events with a history of CVD was 2.326 (95% CI, 1.168–4.630; P = 0.016). Besides, patients with CVD, either with decreased lymphocyte count (OR 9.192, 95% CI, 1.410–59.902, P = 0.020) or increased blood urea nitrogen (OR 5.916, 95% CI, 1.072–32.641, P = 0.041), had a higher risk of developing severe events during hospitalization.Conclusions: Patients with CVD history tend to have adverse clinical outcomes after being infected with SARS-COV-2. Decreased lymphocyte counts and increased blood urea nitrogen levels may be risk factors for adverse outcomes in patients with COVID-19, and had CVD. |
| first_indexed | 2024-04-11T21:05:13Z |
| format | Article |
| id | doaj.art-ae40faa993764dc68ae6df1f05bf8ce5 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-11T21:05:13Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-ae40faa993764dc68ae6df1f05bf8ce52022-12-22T04:03:23ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-01-011210.3389/fneur.2021.706478706478Clinical Characteristics, Outcomes, and Risk Factors of Disease Severity in Patients With COVID-19 and With a History of Cerebrovascular Disease in Wuhan, China: A Retrospective StudyMengzhen Li0Zehui He1Jiecong Yang2Qihua Guo3Heng Weng4Jielian Luo5Baoying Gong6Wanzhen Cui7Banghan Ding8Jianwen Guo9Jianwen Guo10The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Clinical Epidemiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Big Medical Data, Health Construction Administration Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Emergency, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaDepartment of Neurology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaState Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaBackground and Purpose: Coronavirus disease 2019 (COVID-19) rapidly resulted in a pandemic. Information on patients with a history of cerebrovascular disease (CVD) infected with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is limited. This study investigated the clinical features and the risk factors of developing adverse outcomes in patients with COVID-19 and with previous CVD.Methods: This was a single-center retrospective clinical study including all the confirmed cases of COVID-19 at Wuhan Huoshenshan Hospital from February 4 to April 7, 2020. Differences in clinical characteristics were compared between patients with and without a history of CVD. The incidences of severe events comprising all-cause death, intensive care unit admission, shock, and mechanical ventilation usage during hospitalization in two groups were compared using propensity score matching analysis and multivariate logistic regression analyses. Besides, the risk factors of developing severe events in patients with COVID-19 who also have history of CVD were analyzed.Results: A total of 2,554 consecutive patients were included in our study, of whom 109 (4.27%) had a medical history of CVD. Patients with CVD tend to be older and with more comorbidities, including hypertension, diabetes, coronary heart disease, and chronic obstructive pulmonary disease. The levels of white blood cell, neutrophil, C-reactive protein, creatine kinase isoenzymes, and lactate dehydrogenase were higher, whereas the levels of lymphocyte and albumin were lower in the CVD group. Compared to those without CVD, patients with CVD were more likely to have severe events after age matching (12.8 vs. 5.7%, P = 0.012). After adjusting for the confounding effects of age, sex, smoking, and comorbidities, the odds ratio for developing severe events with a history of CVD was 2.326 (95% CI, 1.168–4.630; P = 0.016). Besides, patients with CVD, either with decreased lymphocyte count (OR 9.192, 95% CI, 1.410–59.902, P = 0.020) or increased blood urea nitrogen (OR 5.916, 95% CI, 1.072–32.641, P = 0.041), had a higher risk of developing severe events during hospitalization.Conclusions: Patients with CVD history tend to have adverse clinical outcomes after being infected with SARS-COV-2. Decreased lymphocyte counts and increased blood urea nitrogen levels may be risk factors for adverse outcomes in patients with COVID-19, and had CVD.https://www.frontiersin.org/articles/10.3389/fneur.2021.706478/fullCOVID-19cerebrovascular diseaseclinical characteristicsadverse outcomesrisk factors |
| spellingShingle | Mengzhen Li Zehui He Jiecong Yang Qihua Guo Heng Weng Jielian Luo Baoying Gong Wanzhen Cui Banghan Ding Jianwen Guo Jianwen Guo Clinical Characteristics, Outcomes, and Risk Factors of Disease Severity in Patients With COVID-19 and With a History of Cerebrovascular Disease in Wuhan, China: A Retrospective Study Frontiers in Neurology COVID-19 cerebrovascular disease clinical characteristics adverse outcomes risk factors |
| title | Clinical Characteristics, Outcomes, and Risk Factors of Disease Severity in Patients With COVID-19 and With a History of Cerebrovascular Disease in Wuhan, China: A Retrospective Study |
| title_full | Clinical Characteristics, Outcomes, and Risk Factors of Disease Severity in Patients With COVID-19 and With a History of Cerebrovascular Disease in Wuhan, China: A Retrospective Study |
| title_fullStr | Clinical Characteristics, Outcomes, and Risk Factors of Disease Severity in Patients With COVID-19 and With a History of Cerebrovascular Disease in Wuhan, China: A Retrospective Study |
| title_full_unstemmed | Clinical Characteristics, Outcomes, and Risk Factors of Disease Severity in Patients With COVID-19 and With a History of Cerebrovascular Disease in Wuhan, China: A Retrospective Study |
| title_short | Clinical Characteristics, Outcomes, and Risk Factors of Disease Severity in Patients With COVID-19 and With a History of Cerebrovascular Disease in Wuhan, China: A Retrospective Study |
| title_sort | clinical characteristics outcomes and risk factors of disease severity in patients with covid 19 and with a history of cerebrovascular disease in wuhan china a retrospective study |
| topic | COVID-19 cerebrovascular disease clinical characteristics adverse outcomes risk factors |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.706478/full |
| work_keys_str_mv | AT mengzhenli clinicalcharacteristicsoutcomesandriskfactorsofdiseaseseverityinpatientswithcovid19andwithahistoryofcerebrovasculardiseaseinwuhanchinaaretrospectivestudy AT zehuihe clinicalcharacteristicsoutcomesandriskfactorsofdiseaseseverityinpatientswithcovid19andwithahistoryofcerebrovasculardiseaseinwuhanchinaaretrospectivestudy AT jiecongyang clinicalcharacteristicsoutcomesandriskfactorsofdiseaseseverityinpatientswithcovid19andwithahistoryofcerebrovasculardiseaseinwuhanchinaaretrospectivestudy AT qihuaguo clinicalcharacteristicsoutcomesandriskfactorsofdiseaseseverityinpatientswithcovid19andwithahistoryofcerebrovasculardiseaseinwuhanchinaaretrospectivestudy AT hengweng clinicalcharacteristicsoutcomesandriskfactorsofdiseaseseverityinpatientswithcovid19andwithahistoryofcerebrovasculardiseaseinwuhanchinaaretrospectivestudy AT jielianluo clinicalcharacteristicsoutcomesandriskfactorsofdiseaseseverityinpatientswithcovid19andwithahistoryofcerebrovasculardiseaseinwuhanchinaaretrospectivestudy AT baoyinggong clinicalcharacteristicsoutcomesandriskfactorsofdiseaseseverityinpatientswithcovid19andwithahistoryofcerebrovasculardiseaseinwuhanchinaaretrospectivestudy AT wanzhencui clinicalcharacteristicsoutcomesandriskfactorsofdiseaseseverityinpatientswithcovid19andwithahistoryofcerebrovasculardiseaseinwuhanchinaaretrospectivestudy AT banghanding clinicalcharacteristicsoutcomesandriskfactorsofdiseaseseverityinpatientswithcovid19andwithahistoryofcerebrovasculardiseaseinwuhanchinaaretrospectivestudy AT jianwenguo clinicalcharacteristicsoutcomesandriskfactorsofdiseaseseverityinpatientswithcovid19andwithahistoryofcerebrovasculardiseaseinwuhanchinaaretrospectivestudy AT jianwenguo clinicalcharacteristicsoutcomesandriskfactorsofdiseaseseverityinpatientswithcovid19andwithahistoryofcerebrovasculardiseaseinwuhanchinaaretrospectivestudy |