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Impact of cardiometabolic multimorbidity and ethnicity on cardiovascular/renal complications in patients with COVID-19.

  • Norris, Tom1
  • Razieh, Cameron2
  • Zaccardi, Francesco3, 2
  • Yates, Thomas2
  • Islam, Nazrul4
  • Gillies, Clare L2
  • Chudasama, Yogini V2
  • Rowlands, Alex V2
  • Davies, Melanie J2
  • McCann, Gerry P5
  • Banerjee, Amitava6
  • Lam, Carolyn S P7
  • Docherty, Annemarie B8
  • Openshaw, Peter Jm9
  • Baillie, J Kenneth10
  • Semple, Malcolm Gracie11
  • Lawson, Claire Alexandra3, 5
  • Khunti, Kamlesh3, 2
  • 1 Leicester Real World Evidence Unit, Leicester General Hospital, Leicester, UK [email protected]
  • 2 Diabetes Research Centre, University of Leicester, Leicester, Leicestershire, UK.
  • 3 Leicester Real World Evidence Unit, Leicester General Hospital, Leicester, UK.
  • 4 Big Data Institute, University of Oxford, Oxford, Oxfordshire, UK.
  • 5 Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
  • 6 Farr Institute of Health Informatics Research, University College London, London, UK.
  • 7 Department of Cardiology, National Heart Centre Singapore, Singapore. , (Singapore)
  • 8 Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, Edinburgh, UK.
  • 9 Imperial College London, London, UK.
  • 10 The Roslin Institute, The University of Edinburgh, Easter Bush Campus, Midlothian, UK.
  • 11 University of Liverpool, Liverpool, UK.
Published Article
Publication Date
Jul 13, 2022
DOI: 10.1136/heartjnl-2021-320047
PMID: 34911741


Using a large national database of people hospitalised with COVID-19, we investigated the contribution of cardio-metabolic conditions, multi-morbidity and ethnicity on the risk of in-hospital cardiovascular complications and death. A multicentre, prospective cohort study in 302 UK healthcare facilities of adults hospitalised with COVID-19 between 6 February 2020 and 16 March 2021. Logistic models were used to explore associations between baseline patient ethnicity, cardiometabolic conditions and multimorbidity (0, 1, 2, >2 conditions), and in-hospital cardiovascular complications (heart failure, arrhythmia, cardiac ischaemia, cardiac arrest, coagulation complications, stroke), renal injury and death. Of 65 624 patients hospitalised with COVID-19, 44 598 (68.0%) reported at least one cardiometabolic condition on admission. Cardiovascular/renal complications or death occurred in 24 609 (38.0%) patients. Baseline cardiometabolic conditions were independently associated with increased odds of in-hospital complications and this risk increased in the presence of cardiometabolic multimorbidity. For example, compared with having no cardiometabolic conditions, 1, 2 or ≥3 conditions was associated with 1.46 (95% CI 1.39 to 1.54), 2.04 (95% CI 1.93 to 2.15) and 3.10 (95% CI 2.92 to 3.29) times higher odds of any cardiovascular/renal complication, respectively. A similar pattern was observed for all-cause death. Compared with the white group, the South Asian (OR 1.19, 95% CI 1.10 to 1.29) and black (OR 1.53 to 95% CI 1.37 to 1.72) ethnic groups had higher risk of any cardiovascular/renal complication. In hospitalised patients with COVID-19, cardiovascular complications or death impacts just under half of all patients, with the highest risk in those of South Asian or Black ethnicity and in patients with cardiometabolic multimorbidity. © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.

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