The clinical manifestation and outcome of COVID-19 in patients with a history of ischemic heart disease (IHD); a retrospective case-control study

Abstract

Abstract Background Coronary artery disease (CAD) is considered an independent risk factor for COVID-19. However, no study has specifically examined the clinical manifestations and outcomes of COVID-19 in patients with ischemic heart disease. Methods In a retrospective case-control study between 20 March 2020 to 20 May 2020, the medical record of 1611 patients with laboratory-confirmed SARS-CoV-2 infection was reviewed. Ischemic heart disease was defined as an abnormal coronary angiography, coronary angioplasty, coronary artery bypass graft (CABG), or chronic stable angina. Demographic data, past medical history, drug history, symptoms, vital signs, laboratory findings, outcome, and death were investigated from medical records. Results 1518 Patients (882 men (58.1%)) with a mean age of 59.3 ± 15.5 years were included in the study. Patients with IHD (n = 300) were significantly less likely to have fever (OR: 0.57, 95% CI: 0.42–0.78, P < 0.001), chills (OR: 0.64, 95% CI: 0.47–0.86, P < 0.001) and diarrhea (OR: 0.66, 95% CI: 0.48–0.91, P = 0.010). The mean symptoms duration was 7.74 ± 5.67 days and 8.23 ± 6.12 days in patients with IHD and without IHD, respectively (P = 0.219). Patients with IHD were 1.57 times more likely to have hypoxia (83.3% vs. 76%, OR: 1.57, 95% CI: 1.13–2.19, P = 0.007). There was no significant difference in terms of WBC, platelets, lymphocyte, LDH, AST, ALT, and CRP between the two groups (P > 0.05). After adjusting for age, and underlying disease by Cox proportional hazards regression models and unstandardized confidants by linear regression models, the frequency of ICU admission, length of ICU admission, the frequency of mechanical ventilation, length of mechanical ventilation, death, and time from admission to death were not statistically different between the two groups (P > 0.05). Conclusions In comparison with non-IHD, the symptoms of SARS-CoV-2 infection such as fever, chills and diarrhea were less common among patients with a history of IHD. Although the frequency of hypoxemia was significantly higher in patients with IHD, the rate of adverse outcomes and mortality were not significantly different between the groups.