Title : Association between cardiometabolic risk factors and COVID-19 severity in patients of a rural tertiary hospital
Abstract:
Background: The COVID-19 pandemic has had a significant impact on the world leading to significant morbidity and mortality. The disease was caused by the SARS-CoV-2 virus and can caused severe respiratory illness, as well as a range of other complications depending on presence of cardiometabolic risks. These factors included a range of conditions such as obesity, high blood pressure, high cholesterol, and states of insulin resistance. People with these risk factors are hypothesized to more likely experience severe COVID-19 symptoms and have worse clinical outcomes.
Objective: To determine the association between cardiometabolic risk factors and the development of severe COVID-19 patients in rural tertiary hospital in Bayombong, Nueva Vizcaya.
Methods: We reviewed the medical records of patients aged 19 years or older with a real-time polymerase chain reaction (RT-PCR)–confirmed COVID-19 hospitalized at the Region II Trauma and Medical Center in Bayombong, Nueva Vizcaya. A retrospective correlation design was utilized for the study, using a review of the medical records of patients from March 2020 to December 2022. Fasting plasma glucose (FPG), Low Density Lipoprotein-Cholesterol (LDL-C) levels, Hypertension, BMI, Waist to hip ratio and demographic characteristics of the patients were recorded. A simple and multiple ordinal logistic regression was done to checked the association between COVID-19 and different independent variables. All analyses were performed using STATA SE 18.0, with a p-value of less than 0.05 as the cut-off to determine statistical significance.
Result: We enrolled 1,582 participants; most were 50 to 59 years old (24.3%), Male (57.7%) and unvaccinated. When we compared our patients’ Hyperlipidemia, FBS and Hypertension directly correlate with length of stay while Myocardial Infarction, Atrial Fibrillation and waist to hip ratio inversely correlate with length of stay measured during the pandemic and the pre-pandemic period, we found a statically significant increased (<0.05). Specifically, older patients, with hyperlipidemia, those with confirmed diabetes and elevated BP had a higher probability of staying in the hospital for more than a week while those with MI, AF, and higher WHR tend to stay shorter. In- hospital mortality, COVID patients with Myocardial Infarction 27.3 times (OR: 27.3, p<0.001), Atrial Fibrillation 5.8 times (OR: 5, p<0.001), and high 2 BP 10.4 times (OR: 10.4, p=0.007) odds of dying compared when they don’t have these conditions. Crudely, vaccination decreased the odds of having severe COVID-19, while the rest of the predictors, aside from sex, type 1 DM, and obesity increase the odds. On multiple ordinal logistic regression analysis, however, only vaccination status was associated with decreased severity of COVID-19. Specifically, a vaccinated patient has 53% less odds of having severe COVID-19.
Conclusion: This study demonstrates the consequences of Diabetes Mellitus, Hypertension, Hyperlipidemia and Cardiovascular Disease showed significant associations with mortality and Clinical Severity of patients. Moreover, Age, Male, and Co-morbidities were significant confounders for the associations of Cardiometabolic Risk Factors on COVID-19 mortality and clinical severity.
