Effect of Underlying Cardiovascular Disease on the Prog-nosis of COVID-19 Patients; a Sex and Age-DependentAnalysis

Adults with underlying medical disorders are at increased risk for severe illness from the virusthat causes COVID-19. This study aimed to compare the effect of underlying diseases on the mortality of maleand female patients as a primary objective. We also evaluated the effect of drugs previously used by COVID-19patients on their outcome.

This retrospective cohort study was carried out on confirmed cases ofCOVID-19 who were admitted to a teaching hospital in Tehran, Iran. Data was gathered from patients’ files. Logbinomial model was used for investigating the association of underlying diseases and in-hospital mortality ofthese patients.

A total of 991 patients (mean age 61.62±17.02; 54.9% male) were recruited. Hyperten-sion (41.1%), diabetes mellitus (30.6%), and coronary artery disease (19.6%) were the most common underlyingdiseases. The multivariable model showed that hypertension (RR = 1.62; 95% CI: 1.22-2.14, p = 0.001) in malepatients over 55 years old and coronary artery disease (RR = 2.40; 95% CI: 1.24-4.46, p = 0.009) in female patientsunder 65 years old were risk factors of mortality. In females over 65 years old, the history of taking AngiotensinConverting Enzyme inhibitors (ACEi) and Angiotensin Receptor Blockers (ARB) (RR = 0.272; 95% CI: 0.17-0.41,p = 0.001) was a significant protective factor for death.

COVID-19 patients with a history of car-diovascular diseases such as hypertension and coronary artery disease, especially those in specific age and sexgroups, are high-risk patients for in-hospital mortality. Additionally, a previous history of taking ACEi and ARBmedications in females over 65 tears old was a protective factor against in-hospital mortality of COVID-19 pa-tients.