TY - JOUR
T1 - Cardiovascular outcomes in patients with chronic kidney disease and COVID-19
T2 - a multi-regional data-linkage study
AU - Lambourg, Emilie J.
AU - Gallacher, Peter J.
AU - Hunter, Robert W.
AU - Siddiqui, Moneeza
AU - Miller-Hodges, Eve
AU - Chalmers, James
AU - Pugh, Dan
AU - Dhaun, Neeraj
AU - Bell, Samira
N1 - Funding Information:
Cohort 1 of this study was funded by a special project award from the Scottish Funding Council Data-Driven Innovation Beacon Programme (PJG/RWH/ND). EL’s PhD is supported by The University of Dundee. PJG is supported by a Clinical Research Training Fellowship from the British Heart Foundation (FS/CRTF/20/24079). RWH is supported by a Fellowship from the Wellcome Trust (209562/Z/17/Z). ND is supported by a Senior Clinical Research Fellowship from the Chief Scientist Office (SCAF/19/02). SB is supported by The University of Dundee.
Copyright ©The authors 2022.
PY - 2022/5/12
Y1 - 2022/5/12
N2 - Background: Data describing cardiovascular outcomes in patients with COVID-19 and chronic kidney disease (CKD) are lacking. We compared cardiovascular outcomes of patients with and without COVID-19, stratified by CKD status.Methods: This retrospective, multi-regional data-linkage study utilised individual patient-level data from two Scottish cohorts. All patients tested for SARS-CoV-2 in Cohort 1 between 01/02/2020 and 31/03/2021, and in Cohort 2 between 28/02/2020 and 08/02/2021, were included.Results: Overall, 86 964 patients were tested for SARS-CoV-2. There were 36 904 patients (61±21 years, 58.1% women, 15.9% CKD, 10.1% COVID-19 positive) in Cohort 1 and 50 060 patients (63±20 years, 62.0% women, 16.4% CKD, 9.1% COVID-19 positive) in Cohort 2. In CKD patients, COVID-19 increased the risk of cardiovascular death by more than two-fold within 30 days (cause-specific hazard ratio [csHR] meta-estimate 2.34, 95% confidence interval [CI] 1.83-2.99), and by 57% at the end of follow-up (csHR meta-estimate 1.57, 95% CI 1.31-1.89). Similarly, the risk of all-cause death in COVID-19 positive versus negative CKD patients was greatest within 30 days (HR 4.53, 95% CI 3.97-5.16). Compared to patients without CKD, those with CKD had a higher risk of testing positive (11.5% versus 9.3%). Following a positive test, CKD patients had higher rates of cardiovascular death (11.1% versus 2.7%), cardiovascular complications, and cardiovascular hospitalisations (7.1% versus 3.3%) than those without CKD.Conclusions: COVID-19 increases the risk of cardiovascular and all-cause death in CKD patients, especially in the short-term. CKD patients with COVID-19 are also at a disproportionate risk of cardiovascular complications than those without CKD.
AB - Background: Data describing cardiovascular outcomes in patients with COVID-19 and chronic kidney disease (CKD) are lacking. We compared cardiovascular outcomes of patients with and without COVID-19, stratified by CKD status.Methods: This retrospective, multi-regional data-linkage study utilised individual patient-level data from two Scottish cohorts. All patients tested for SARS-CoV-2 in Cohort 1 between 01/02/2020 and 31/03/2021, and in Cohort 2 between 28/02/2020 and 08/02/2021, were included.Results: Overall, 86 964 patients were tested for SARS-CoV-2. There were 36 904 patients (61±21 years, 58.1% women, 15.9% CKD, 10.1% COVID-19 positive) in Cohort 1 and 50 060 patients (63±20 years, 62.0% women, 16.4% CKD, 9.1% COVID-19 positive) in Cohort 2. In CKD patients, COVID-19 increased the risk of cardiovascular death by more than two-fold within 30 days (cause-specific hazard ratio [csHR] meta-estimate 2.34, 95% confidence interval [CI] 1.83-2.99), and by 57% at the end of follow-up (csHR meta-estimate 1.57, 95% CI 1.31-1.89). Similarly, the risk of all-cause death in COVID-19 positive versus negative CKD patients was greatest within 30 days (HR 4.53, 95% CI 3.97-5.16). Compared to patients without CKD, those with CKD had a higher risk of testing positive (11.5% versus 9.3%). Following a positive test, CKD patients had higher rates of cardiovascular death (11.1% versus 2.7%), cardiovascular complications, and cardiovascular hospitalisations (7.1% versus 3.3%) than those without CKD.Conclusions: COVID-19 increases the risk of cardiovascular and all-cause death in CKD patients, especially in the short-term. CKD patients with COVID-19 are also at a disproportionate risk of cardiovascular complications than those without CKD.
U2 - 10.1183/13993003.03168-2021
DO - 10.1183/13993003.03168-2021
M3 - Article
C2 - 35551093
JO - European Respiratory Journal
JF - European Respiratory Journal
SN - 0903-1936
ER -