학술논문
Combined Cardiac Risk Factors Predict COVID-19 Related Mortality and the Need for Mechanical Ventilation in Coptic Clergy.
Document Type
Academic Journal
Author
Henein MY; Institute of Public Health and Clinical Medicine, Umea University, 90187 Umea, Sweden.; Molecular and Clinic Research Institute, St George University, London SW17 0QT, UK.; Institute of Fluid Dynamics, Brunel University, London UB8 3PH, UK.; Bytyçi I; Institute of Public Health and Clinical Medicine, Umea University, 90187 Umea, Sweden.; Nicoll R; Institute of Public Health and Clinical Medicine, Umea University, 90187 Umea, Sweden.; Shenouda R; Institute of Public Health and Clinical Medicine, Umea University, 90187 Umea, Sweden.; International Cardiac Centre, Alexandria 21526, Egypt.; Ayad S; Department of Cardiology, Faculty of Medicine, Alexandria University, Alexandria 21526, Egypt.; Cameli M; Department of Cardiovascular Disease, University of Siena, 53100 Siena, Italy.; Vancheri F; Department of Internal Medicine, S. Elia Hospital, 93100 Caltanissetta, Italy.
Source
Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101606588 Publication Model: Electronic Cited Medium: Print ISSN: 2077-0383 (Print) Linking ISSN: 20770383 NLM ISO Abbreviation: J Clin Med Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2077-0383
Abstract
Background and Aims: The clinical adverse events of COVID-19 among clergy worldwide have been found to be higher than among ordinary communities, probably because of the nature of their work. The aim of this study was to assess the impact of cardiac risk factors on COVID-19-related mortality and the need for mechanical ventilation in Coptic clergy.
Methods: Of 1570 Coptic clergy participating in the COVID-19-Clergy study, serving in Egypt, USA and Europe, 213 had the infection and were included in this analysis. Based on the presence of systemic arterial hypertension (AH), participants were divided into two groups: Group-I, clergy with AH ( n = 77) and Group-II, without AH ( n = 136). Participants' demographic indices, cardiovascular risk factors, COVID-19 management details and related mortality were assessed.
Results: Clergy with AH were older ( p < 0.001), more obese ( p = 0.04), had frequent type 2 diabetes (DM) ( p = 0.001), dyslipidemia ( p = 0.001) and coronary heart disease (CHD) ( p = 0.04) compared to those without AH. COVID-19 treatment at home, hospital or in intensive care did not differ between the patient groups ( p > 0.05 for all). Clergy serving in Northern and Southern Egypt had a higher mortality rate compared to those from Europe and the USA combined (5.22%, 6.38%, 0%; p = 0.001). The impact of AH on mortality was significant only in Southern Egypt (10% vs. 3.7%; p = 0.01) but not in Northern Egypt (4.88% vs. 5.81%; p = 0.43). In multivariate analysis, CHD OR 1.607 ((0.982 to 3.051); p = 0.02) and obesity, OR 3.403 ((1.902 to 4.694); p = 0.04) predicted COVID-19 related mortality. A model combining cardiac risk factors (systolic blood pressure (SBP) ≥ 160 mmHg, DM, obesity and history of CHD) was the most powerful independent predictor of COVID-19-related mortality, OR 3.991 ((1.919 to 6.844); p = 0.002). Almost the same model also proved the best independent multivariate predictor of mechanical ventilation OR 1.501 ((0.809 to 6.108); p = 0.001).
Conclusion: In Coptic clergy, the cumulative impact of risk factors was the most powerful predictor of mortality and the need for mechanical ventilation.
Methods: Of 1570 Coptic clergy participating in the COVID-19-Clergy study, serving in Egypt, USA and Europe, 213 had the infection and were included in this analysis. Based on the presence of systemic arterial hypertension (AH), participants were divided into two groups: Group-I, clergy with AH ( n = 77) and Group-II, without AH ( n = 136). Participants' demographic indices, cardiovascular risk factors, COVID-19 management details and related mortality were assessed.
Results: Clergy with AH were older ( p < 0.001), more obese ( p = 0.04), had frequent type 2 diabetes (DM) ( p = 0.001), dyslipidemia ( p = 0.001) and coronary heart disease (CHD) ( p = 0.04) compared to those without AH. COVID-19 treatment at home, hospital or in intensive care did not differ between the patient groups ( p > 0.05 for all). Clergy serving in Northern and Southern Egypt had a higher mortality rate compared to those from Europe and the USA combined (5.22%, 6.38%, 0%; p = 0.001). The impact of AH on mortality was significant only in Southern Egypt (10% vs. 3.7%; p = 0.01) but not in Northern Egypt (4.88% vs. 5.81%; p = 0.43). In multivariate analysis, CHD OR 1.607 ((0.982 to 3.051); p = 0.02) and obesity, OR 3.403 ((1.902 to 4.694); p = 0.04) predicted COVID-19 related mortality. A model combining cardiac risk factors (systolic blood pressure (SBP) ≥ 160 mmHg, DM, obesity and history of CHD) was the most powerful independent predictor of COVID-19-related mortality, OR 3.991 ((1.919 to 6.844); p = 0.002). Almost the same model also proved the best independent multivariate predictor of mechanical ventilation OR 1.501 ((0.809 to 6.108); p = 0.001).
Conclusion: In Coptic clergy, the cumulative impact of risk factors was the most powerful predictor of mortality and the need for mechanical ventilation.