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Factors Associated With Mortality in Hospitalized Cardiovascular Disease Patients Infected With COVID-19

Background: To reduce mortality in hospitalized patients with COVID-19 and cardiovascular disease (CVD), it is necessary to understand the relationship between patient’s symptoms, risk factors, and comorbidities with their mortality rate. 
 
Method: To the best of our knowledge, this paper is the first which takes into account the determinants like risk factors, symptoms and comorbidities leading to mortality in CVD patients who are hospitalized with COVID-19. This study was conducted on 6600 hospitalized patients with CVD and COVID-19 recruited between January 2020 and January 2021 in Iran. All patients were diagnosed with previous history of CVD like angina, myocardial infarction, heart failure, cardiomyopathy, abnormal heart rhythms, and congenital heart disease before they were hospitalized for COVID-19. We collected data on patient’s signs and symptoms, clinical and paraclinical examinations, and any underlying comorbidities. t-test was used to determine the significant difference between the two deceased and alive groups. In addition, the relation between pairs of symptoms and pairs of comorbidities has been determined via correlation computation. 
 
Findings: Our findings suggest that signs and symptoms such as fever, cough, myalgia, chest pain, chills, abdominal pain, nausea, vomiting, diarrhea, and anorexia had no impact on patients' mortality. There was a significant correlation between COVID-19 cardiovascular patients’ mortality rate and symptoms such as headache, Loss of consciousness (LOC), oxygen saturation less than 93%, and need for mechanical ventilation. We observed no relationship in cardiac cases between mortality and comorbidities such as diabetes, cancer, pulmonary diseases, renal diseases, hematologic disorders, neurological diseases, and hypertension. The only risk factor that has impact on patients’ mortality was age. Other risk factors such as smoking status or addiction had no impact. 
 
Interpretation: Our results might help physicians identify early symptoms, comorbidities, and risk factors related to mortality in cardiovascular disease patients hospitalized for COVID-19. 
 
Funding Information: There is no funding. 
 
Declaration of Interests: The authors declare that there is no conflict of interest. 
 
Ethics Approval Statement: The study was approved by the Semnan Hospital Ethics Committee. All the patients completed written consent form before their enrolment in the data collection procedure.