Clinical characteristics and outcomes of COVID-19 patients with a history of cardiovascular disease

Tofigh Yaghubi, Vahid Shakoori, Sara Nasiri, Mona Keivan, Chanour Tavakol, Shahin Ahanjide, Ali Alavi Foumani, Samaneh Mirzaei Dahka, Mohammad Sadegh Esmaeili Delshad, Niloofar Faraji


New emerging severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) primarily affects the lungs, but the virus may cause cardiovascular disease (CVD), and a history of CVD is usually associated with comorbidities, which could increase the severity of infections. In this study, we collected demographic and clinical characteristics data from 123 patients with a history of CVD, who were confirmed to have SARS-CoV-2 infection by polymerase chain reaction (PCR) test in Razi Hospital, Rasht, Iran, from March 2021 to June 2021. Chi-Square and Fisher's Exact test with a significance level of P less than 0.05 was performed. All statistical analysis was performed with SPSS software version 26.0. Among the studied patients, 99 patients were discharged and 24 of them died. 62 (50.4%) of the study population were female and 61 (49.6%) were male, and there is no significant association between gender and the outcome of patients (P = 0.159). The total mean age of patients was 68.35±12.41. Statistical analysis has represented a significant relation of death outcomes in CVD patients with age 60 years and older (P = 0.001), in comparison with patients younger than 60 years. In this present study, no significant relation between underlying disease and mortality rate was reported, but in COVID-19 patients with a history of CVD and age upper than 60 years, death outcome was more probable.


COVID-19; SARS-CoV-2; Cardiovascular disease; Clinical characteristic; Underlying disease

Full Text:

Full-text PDF


Chan JF, Kok KH, Zhu Z, Chu H, To KK, Yuan S, et al. Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan. Emerg Microbes Infect. 2020; 9(1):221-36.

Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle. J Med Virol. 2020; 92(4):401-2.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395(10223):507-13.

Chen Q, Xu L, Zhu W, Ge J. Cardiovascular manifestations in severe and critical patients with COVID-19. Clin Cardiol. 2020; 43(10):1054.

Kunutsor SK, Laukkanen JA. Renal complications in COVID-19: a systematic review and meta-analysis. Ann Med. 2020; 52(7):345-53.

Zhang X, Yang X, Jiao H, Liu X. Coagulopathy in patients with COVID-19: a systematic review and meta-analysis. Aging (Albany NY). 2020; 12(24):24535-51.

Zhao Y, Zhao Z, Wang Y, Zhou Y, Ma Y, Zuo W. Single-Cell RNA Expression Profiling of ACE2, the Receptor of SARS-CoV-2. Am J Respir Crit Care Med. 2020; 202(5):756-9.

Tikellis C, Thomas MC. Angiotensin-Converting Enzyme 2 (ACE2) Is a Key Modulator of the Renin Angiotensin System in Health and Disease. Int J Pept. 2012; 2012:256294.

Djomkam ALZ, Olwal CO, Sala TB, Paemka L. Commentary: SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Front Oncol. 2020; 10:1448.

Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Biondi-Zoccai G, et al. Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic. J Am Coll Cardiol. 2020; 75(18):2352-71.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223):497-506.

Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020; 46(5):846-8.

Doyen D, Moceri P, Ducreux D, Dellamonica J. Myocarditis in a patient with COVID-19: a cause of raised troponin and ECG changes. Lancet. 2020; 395(10235):1516.

Ratchford SM, Stickford JL, Province VM, Stute N, Augenreich MA, Koontz LK, et al. Vascular alterations among young adults with SARS-CoV-2. Am J Physiol Heart Circ Physiol. 2021; 320(1):H404-h10.

Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020; 17(5):259-60.

Emami A, Javanmardi F, Pirbonyeh N, Akbari A. Prevalence of Underlying Diseases in Hospitalized Patients with COVID-19: a Systematic Review and Meta-Analysis. Arch Acad Emerg Med. 2020; 8(1):e35.

Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, Al-Rabiah FA, Al-Hajjar S, Al-Barrak A, et al. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect Dis. 2013; 13(9):752-61.

Noorwali AA, Turkistani AM, Asiri SI, Trabulsi FA, Alwafi OM, Alzahrani SH, et al. Descriptive epidemiology and characteristics of confirmed cases of Middle East respiratory syndrome coronavirus infection in the Makkah Region of Saudi Arabia, March to June 2014. Ann Saudi Med. 2015; 35(3):203-9.

Wang R, Hozumi Y, Zheng YH, Yin C, Wei GW. Host Immune Response Driving SARS-CoV-2 Evolution. Viruses. 2020; 12(10).

Mertz D, Kim TH, Johnstone J, Lam PP, Science M, Kuster SP, et al. Populations at risk for severe or complicated influenza illness: systematic review and meta-analysis. Bmj. 2013; 347:f5061.

de Almeida-Pititto B, Dualib PM, Zajdenverg L, Dantas JR, de Souza FD, Rodacki M, et al. Severity and mortality of COVID 19 in patients with diabetes, hypertension and cardiovascular disease: a meta-analysis. Diabetol Metab Syndr. 2020; 12:75.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. Jama. 2020; 323(11):1061-9.

Peng YD, Meng K, Guan HQ, Leng L, Zhu RR, Wang BY, et al. [Clinical characteristics and outcomes of 112 cardiovascular disease patients infected by 2019-nCoV]. Zhonghua Xin Xue Guan Bing Za Zhi. 2020; 48(6):450-5.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229):1054-62.

Alshaikh MK, Alotair H, Alnajjar F, Sharaf H, Alhafi B, Alashgar L, et al. Cardiovascular Risk Factors Among Patients Infected with COVID-19 in Saudi Arabia. Vasc Health Risk Manag. 2021; 17:161-8.

Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020; 395(10223):514-23.

Bonow RO, Fonarow GC, O'Gara PT, Yancy CW. Association of Coronavirus Disease 2019 (COVID-19) With Myocardial Injury and Mortality. JAMA Cardiol. 2020; 5(7):751-3.

Shi Q, Zhang X, Jiang F, Zhang X, Hu N, Bimu C, et al. Clinical Characteristics and Risk Factors for Mortality of COVID-19 Patients With Diabetes in Wuhan, China: A Two-Center, Retrospective Study. Diabetes Care. 2020; 43(7):1382-91.

Mubarik S, Liu X, Eshak ES, Liu K, Liu Q, Wang F, et al. The Association of Hypertension With the Severity of and Mortality From the COVID-19 in the Early Stage of the Epidemic in Wuhan, China: A Multicenter Retrospective Cohort Study. Front Med (Lausanne). 2021; 8:623608.

Choudhary NS, Dhampalwar S, Saraf N, Soin AS. Outcomes of COVID-19 in Patients with Cirrhosis or Liver Transplantation. J Clin Exp Hepatol. 2021; 11(6):713-9.

Cai R, Zhang J, Zhu Y, Liu L, Liu Y, He Q. Mortality in chronic kidney disease patients with COVID-19: a systematic review and meta-analysis. Int Urol Nephrol. 2021; 53(8):1623-9.

Meza D, Khuder B, Bailey JI, Rosenberg SR, Kalhan R, Reyfman PA. Mortality from COVID-19 in Patients with COPD: A US Study in the N3C Data Enclave. Int J Chron Obstruct Pulmon Dis. 2021; 16:2323-6.

Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020; 180(7):934-43.



  • There are currently no refbacks.

Copyright (c) 2022 © The Author(s)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.