Association of Cardiovascular Manifestations with In-hospital Outcomes in Patients with COVID-19: A Hospital Staff Data

  1. Ru Liu
  2. Xiaoyan Ming
  3. Ou Xu
  4. Jianli Zhou
  5. Hui Peng
  6. Ning Xiang
  7. Jiaming Zhang
  8. Hong Zhu

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Abstract

Background

The outbreaks of coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain a huge threat to the public health worldwide. Clinical data is limited up to now regarding the risk factors in favor of severe conversion of non-severe case with COVID-19.

Aims

This study analyzed a hospital staff data to figure out general clinical features of COVID-19 in terms of the association of cardiovascular manifestations (CVMs) with in-hospital outcomes of COVID-19 cases.

Methods

Retrospective, single-center case series of 41 consecutive hospitalized health staff with confirmed COVID-19 were collected at the Central Hospital of Wuhan in Wuhan, China, from January 15 to January 24, 2020. Epidemiological, demographic, clinical, laboratory, radiological, treatment data and in-hospital adverse events were collected and analyzed. Final date of follow-up was March 3, 2020. A comparative study was applied between cases with CVMs and those without CVMs.

Results

Of all, clinicians and clinical nurses accounted for 80.5%, while 87.8% of all had history of patient contact. The population was presented with a mean age of 39.1 ± 9.2 and less comorbidities than community population. The three most frequent symptoms of COVID-19 cases analyzed were fever (82.9%), myalgia or fatigue (80.5%) and cough (63.4%). While, the three most frequent initial symptoms were myalgia or fatigue (80.5%), fever (73.2%) and cough (41.5%). There were 95.1% cases featured as non-severe course of disease according to the official standard in China. Patients with CVMs and those without CVMs accounted for 58.5% and 41.5%, respectively. Compared with cases without CVMs, patients with CVMs were presented with lower baseline lymphocyte count (0.99 ± 0.43 and 1.55 ± 0.61, P <0.001), more who had at least once positive nucleic acid detection of throat swab during admission (50.0% and 11.8%, P =0.011), and more received oxygen support (79.2% and 23.5%, P <0.001). The rate of in-hospital adverse events was significantly higher in patients with CVMs group (75.0% and 23.5%, P =0.001). Multivariable logistic regression model indicated that, coexisting with CVMs in COVID-19 patients was not independently associated with in-hospital adverse events.

Conclusions

Most of hospital staff with COVID-19 had history of patient contact, featured non-severe course of disease. Cases with CVMs suffered from more in-hospital adverse events than those without CVMs. But concomitant CVMs were not independently associated with in-hospital adverse events in COVID-19 patients.

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  1. ScreenIT

    SciScore for 10.1101/2020.02.29.20029348: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Ethical Statement: As a retrospective study and data analysis were performed anonymously, the requirement for informed consent was waived.
    IRB: The Ethics Committees of the Central Hospital of Wuhan approved this study.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical Analysis: Data statistics was applied using SPSS 22.0 (IBM Corp., Armonk
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitation: Firstly, the cases enrolled in this study were only hospital staff. The conclusion cannot be extrapolated to common community patients. Secondly, as the suddenness of the outbreak, the vast patient volume in hospitals and shortage of healthcare personnel, it is hard to obtain large clinical data. The sample is not large enough for observation of mortality in severe cases of COVID-19. The multivariate model analysis had limitation due to the sample size. And we cannot figure up how the research variable effected each adverse in-hospital event. Lastly, the in-hospital outcomes were monitored up to March 3, 2020, the final date of follow-up. The incomplete follow-up data will be made up constantly. Besides, we are trying to collect the data of the severe case who transferred to other hospital. Nevertheless, this is first-hand data in terms of hospital staff infection in Wuhan, and the first analysis comparing the in-hospital outcomes of COVID-19 between cases with CVMs and those without CVMs, in anticipation of finding the risk factors in favor of severe conversion of non-severe case.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.02.29.20029348 on medRxiv