“Those who succumbed to the disease within 30 days of being hospitalised more often presented with significantly higher heart rate, lower diastolic blood pressures, shortness of breath and more frequently had hypertension, diabetes, coronary heart disease, atrial fibrillation, rheumatic heart disease, Chagas disease, valvular disease, and chronic kidney disease,” the study published in Global Heart, the official journal of the World Heart Federation points out.
Of the 5,313 patients who were hospitalised, the study found, 683 (12.9%) individuals died in hospital, and 118 (2.6%) died post-discharge up to 30-days follow-up. Overall, mean age (SD) was 57 years, 59% were men. The mean BMI (Body Mass Index) was 26.9 (5.3) Kg/m2, and 25% of the participants were overweight (BMI 25–29) and 15.6% were obese (BMI30 Kg/m2).
Compared to high income countries (HIC) where in-hospital death rate stood at 4%, Covid-19 patients recruited from low-income countries had a higher in-hospital death rate of 10%. The in-hospital death rate in lower-middle income countries (LMIC) and upper-middle-income countries (UMIC) stood at 15% and 19% respectively.
“The World Heart Federation and PHFI study was conducted to better understand outcomes among hospitalized patients with the infection. This study aimed to bridge the Covid-19 research gap from LMICs and make a comparison with High income countries.The study demonstrated that patients were relatively younger as compared to previous publications (average age of 57 years), predominantly middle aged men, with high prevalence of cardiovascular risk factors such as hypertension diabetes and high mortality up to 30 days. Patients of Asian, Hispanic or Black ethnicities had higher death rates both within the hospital and after discharge as compared to white Caucasians,” Dr Prabhakaran said.
He added that the analysis with regards to the Indian population has shown that South Asians (Indians) in the middle-aged to elderly group died more frequently than other regions due to Covid hospitalizations, and had significantly greater background prevalence of diabetes and hypertension. “Indians have a greater prevalence of Diabetes and Hypertension and this may be driving the higher mortality in South Asians,” Dr Prabhakaran, who is vice-president (research and policy) at PHFI, said.
“It is important to note that 20 % of the deaths up to 30 days after covid were sudden cardiac deaths and can be attributed to arrhythmias and heart attacks. This emphasises the need for cardiac precautions and surveillance even after discharge from the hospital,” Dr Ashok Seth, chairman of Fortis Escorts Heart Institute, said while commenting on the study findings.
In a study, which was published in the European Heart Journal (EHJ) recently, medical researchers from University of Oxford, University of Zurich and the University of Wisconsin School of Medicine and Public Health advised that persons who are at high risk to develop heart diseases, for example those with diabetes and hypertension or a history of heart ailments, should undergo a thorough screening to assess heart health in 8-12 weeks of recovery from Covid-19.
“If there is any abnormality, such persons may also require additional testing,” they said. The researchers said Covid-19 can cause both acute and chronic injury to the heart by various mechanisms including direct damage to the cells, the formation of clot and inflammation in blood vessels and the triggering of an autoimmune response.