Dataset Information

Severe COVID-19 outcomes by cardiovascular risk profile in England in 2020: a population-based cohort study.

ABSTRACT:

Background

While cardiovascular disease (CVD) is a risk factor for severe COVID-19, the association between predicted cardiovascular risk and severe COVID-19 among people without diagnosed CVD is unclear.

Methods

We carried out historical, population-based cohort studies among adults aged 40-84 years in England using linked data from the Clinical Practice Research Datalink. Individuals were categorized into: existing CVD, raised cardiovascular risk (defined using QRISK3 score ≥10%) and low risk (QRISK3 score <10%) at 12/03/2020. We described incidence and severe outcomes of COVID-19 (deaths, intensive care unit [ICU] admissions, hospitalisations, major adverse cardiovascular events [MACE]) for each group. Among those with a COVID-19 record to 31/12/2020, we re-classified cardiovascular risk at infection and assessed the risk of severe outcomes using multivariable Cox regression with complete case analysis. We repeated analyses using hypertension to define raised cardiovascular risk.

Findings

Among 6,059,055 individuals, 741,913 (12.2%) had established CVD, 1,929,627 (31.8%) had a QRISK3 score ≥10% and 3,387,515 (55.9%) had a QRISK3 score <10%. Marked gradients were seen in the incidence of all severe COVID-19 outcomes by cardiovascular risk profile. Among those with COVID-19 (N = 146,760), there was a strong association between raised QRISK3 score and death: adjusted hazard ratio [aHR] 8.77 (7.62-10.10), N = 97,725, which remained present, though attenuated in age-stratified results. Risks of other outcomes were also higher among those with raised QRISK3 score: aHR 3.66 (3.18-4.21) for ICU admissions, 3.38 (3.22-3.56) for hospitalisations, 5.43 (4.44-6.64) for MACE. When raised cardiovascular risk was redefined by hypertension status, only the association with MACE remained: aHR 1.49 (1.20-1.85), N = 57,264.

Interpretation

Individuals without pre-existing CVD but with raised cardiovascular risk (by QRISK3 score) were more likely to experience severe COVID-19 outcomes and should be prioritised for prevention and treatment. Addressing cardiovascular risk factors could improve COVID-19 outcomes.

Funding

BMA Foundation for Medical Research/Rosetrees Trust, Wellcome, BHF.

SUBMITTER: Warren-Gash C

PROVIDER: S-EPMC9991014 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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Publications

Severe COVID-19 outcomes by cardiovascular risk profile in England in 2020: a population-based cohort study.

Warren-Gash Charlotte C Davidson Jennifer A JA Strongman Helen H Herrett Emily E Smeeth Liam L Breuer Judith J Banerjee Amitava A

The Lancet regional health. Europe 20230307

<h4>Background</h4>While cardiovascular disease (CVD) is a risk factor for severe COVID-19, the association between predicted cardiovascular risk and severe COVID-19 among people without diagnosed CVD is unclear.<h4>Methods</h4>We carried out historical, population-based cohort studies among adults aged 40-84 years in England using linked data from the Clinical Practice Research Datalink. Individuals were categorized into: existing CVD, raised cardiovascular risk (defined using QRISK3 score ≥10% ...[more]

PMID: 36911072

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Dataset Information

Severe COVID-19 outcomes by cardiovascular risk profile in England in 2020: a population-based cohort study.

Background

Methods

Findings

Interpretation

Funding

Publications

Severe COVID-19 outcomes by cardiovascular risk profile in England in 2020: a population-based cohort study.

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