News: Higher COVID-19 fatality rates for patients with cardiovascular disease

CDI Strategies - Volume 14, Issue 15

A clinical bulletin recently published by the American College of Cardiology reported that the case fatality rate for patients with COVID-19 who have underlying cardiovascular disease (CVD) is approximately 10% higher than for cancer, chronic respiratory disease, and diabetes.

The bulletin contains additional information that is highly relevant for primary care physicians who regularly see patients with CVD and related morbidity. It states that while over 80% of COVID-19 positive patients experience mild symptoms and recover without intensive medical intervention, the mortality rate increases significantly with age, rising from 2.3% to 8% among patients aged 70-79, and 14.8% in patients aged 80 and older. This data is based off of large-scale Chinese case reporting.

Case fatality rates for comorbid patients are materially higher than the average population:

  • No Comorbidities: 0.9%
  • Average Population: 2.3%
  • Cancer: 5.6%
  • Hypertension: 6.0%
  • Chronic respiratory disease: 6.3%
  • Diabetes: 7.3%
  • Cardiovascular disease: 10.5%

The bulletin says that of 138 hospitalized COVID-19 patients, 16.7% developed arrhythmia and 7.2% experienced acute cardiac injury in addition to over novel coronavirus related complications. Cardiac complications of COVID-19 are approximately equivalent with severe acute respiratory syndrome-related coronavirus (SARS), Middle East respiratory syndrome (MERS), and influenza, according to the report.  

The American College of Cardiology suggests that in areas of active COVID-19 outbreak, providers should consider substituting telephonic or telehealth visits for in-person routine visits for stable CVD patients to avoid possible nosocomial COVID-19 infections, noting that planning for emergency telehealth protocols should begin now. The bulletin says it is reasonable to triage novel coronavirus patients according to underlying CVD, diabetes, respiratory, renal, oncological, or other comorbid conditions for prioritized treatment.

Editor’s note: The full COVID-19 Clinical Guidance for the Cardiovascular Care Team bulletin can be found here.

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