Study shows that cardiovascular disease is the comorbidity with the highest mortality risk in COVID-19

A study carried out by a team of researchers from the Faculty of Medicine of the University of Coimbra (FMUC) suggests that cardiovascular disease is a comorbidity with a higher risk of mortality from COVID-19, followed by diabetes.

Conducted by Francisco Caramelo, Nuno Ferreira and Bárbara Oliveiros, this study aimed to determine the risk of mortality from COVID-19 adjusted to age, gender and the presence of comorbidities such as diabetes, hypertension, cardiovascular, respiratory or oncological disease, very prevalent diseases among the Portuguese population.

The work, as the researchers explain, was developed in late February, “immediately after an article from the Chinese CDC [Center for Disease Control] was published, which reported the fatality rate of confirmed cases in China to date, but did not show estimates of the risk of mortality in the presence of one or more characteristics of individuals, representing an added value for the article of the Chinese CDC when quantifying the associated risk “.

In order to estimate the comorbidities with the greatest weight in mortality from the disease caused by the new coronavirus, the team used simple mathematical tools. The adopted approach can be used to determine the probability of death from COVID-19 for a particular patient, given its age group, gender and associated comorbidities.

Since it is already known that the mortality rate affects men more, the elderly, and individuals with associated comorbidities, the study by the FMUC team reports a higher probability of mortality in men, increased by 1.60 to 2.13 times, with 95% confidence. «We also found an increased risk of mortality associated with age, especially from the age of 50, this risk being, on average, 6.76 times greater from this age, 18.82 times greater from the age of 60, 43.73 times higher from 70 years old and 86.87 times higher from 80 years old, when compared with the reference class (up to 20 years old) », underline the researchers.

Although at this moment it is not yet possible to assess these results in the Portuguese population, since the deaths recorded do not include anyone below 40 years of age, according to “DGS” data, “we observe that the distribution of mortality by age group in Portugal is close to what normally occurs in terms of mortality in the Portuguese population by age group, according to information collected in PORDATA. Another important factor is that the presence of any comorbidity, such as diabetes, hypertension, cardiovascular disease, cancer or respiratory disease translates into an increased risk of mortality, with cardiovascular disease being the one with the greatest weight, followed by diabetes », they state.

Commenting on the results obtained, Francisco Caramelo, Nuno Ferreira and Bárbara Oliveiros reinforce the warnings that have been widely disseminated, noting that, “although lethality is not yet high in Portugal, it is estimated that the percentage of severe cases needing ventilation will be very high; in other countries it is approximately 16% and this figure has been known since mid-January (China); situations are known where health professionals have been forced to choose who has access to these units or not. This percentage makes any national health service overburdened if the number of infected people is very high, so it is crucial to reduce the number of infections by restricting social contact ».

Now, like many other scientists, and after having submitted another Paper that assesses the effect of weather conditions on the spread of the disease, the FMUC team is focused on determining “the peak from the estimate of the maximum number of infected cases. We are using artificial intelligence methods, but the models are very dynamic over time and it has not been easy to validate the model, as has been the case with other researchers".

The researchers also provide a daily detailed description with several indicators of the evolution of the disease in Portugal.

This information can be followed up at: https://apps.uc.pt/mypage/faculty/bcpaiva/pt/daily_covid19 and https://covid-pt.blogspot.com/

The preprint of the scientific paper may be found at https://www.medrxiv.org/content/10.1101/2020.02.24.20027268v1

This project is available on the UC Against COVID-19 platform, which brings together all the projects of the University of Coimbra associated with the effects and the fight against the pandemic.

^{Translation by Diana Taborda}