Association between the 10-Year ASCVD risk score and COVID-19 complications among healthy adults (analysis from the National Cohort COVID Collaborative)

Authors

Rasha Khatib, Advocate Aurora HealthFollow
Nicole Glowacki, Advocate Aurora HealthFollow
Julie C. Lauffenburger, Center for Healthcare Delivery Sciences (C4HDS), Department of Medicine, Brigham and Women's Hospital; and Harvard Medical School, Boston, Massachusetts; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital; and Harvard Medical School, Boston, Massachusetts.
Alex Reddy, Advocate Aurora HealthFollow
Kate Dennert, Advocate Aurora HealthFollow
David Triscari, Advocate Aurora HealthFollow

Recommended Citation

Khatib R, Glowacki N, Lauffenburger JC, et al. Association Between the 10-Year ASCVD Risk Score and COVID-19 Complications Among Healthy Adults (Analysis from the National Cohort COVID Collaborative). Am J Cardiol. 2023;202:201-207. doi:10.1016/j.amjcard.2023.05.012

Affiliations

Advocate Aurora Research Institute

Abstract

COVID-19 complications have been linked to worse outcomes among patients with established atherosclerotic cardiovascular disease (ASCVD). Less is known about the cumulative consequences of multiple ASCVD risk factors on COVID-19 outcomes. We evaluated the dose-response associations between 10-year ASCVD risk scores and COVID-19 complications. The National COVID-19 Cohort Collaborative collects electronic health record data from over 70 US health systems. Our analysis was limited to patients with positive COVID-19 tests without documented ASCVD events at the time of the first positive test. We evaluated the dose-response associations between 10-year ASCVD risk scores, categorized into categorized as low (20.0%), and COVID-19 complications, including hospitalizations and mortality. We reported the outcomes using multivariable-adjusted hazard ratios and 95% confidence intervals (CIs). Our cohort included 120,335 patients with documented positive COVID-19 test results who were free of ASCVD events. The mean age was 51.9 ± 16.1 years, 59.4% were women, 15.3% were Black, and 13.7% were Hispanic/Latino. Overall, 15,363 patients (12.8%) were hospitalized and 2,058 (1.7%) died. Patients at intermediate risk of developing ASCVD were had a 1.49 (95% CI 1.41 to 1.56) increased risk of hospitalization and 1.77 (95% CI 1.76 to 1.79) increased risk of mortality compared with patients at low risk. Patients at high risk had a 2.23 (95% CI 2.10 to 2.38) increased risk of hospitalization and a 5.98 (95% CI 5.93 to 6.03) increased risk of mortality. In conclusion, patients in this nationwide cohort at high risk of developing ASCVD are at substantially greater risk of COVID-19 complications. COVID-19 mitigation efforts should focus on these patient populations.

Document Type

Article

PubMed ID

37454637