The effect of vascular risk factor burden on the severity of COVID-19 illness, a retrospective cohort study.
Identifieur interne : 000147 ( Main/Corpus ); précédent : 000146; suivant : 000148The effect of vascular risk factor burden on the severity of COVID-19 illness, a retrospective cohort study.
Auteurs : Houwei Du ; Xiaobin Pan ; Nan Liu ; Junnian Chen ; Xiaoling Chen ; David J. Werring ; Gareth Ambler ; Xiaoqing Li ; Ronghua Chen ; Yixian Zhang ; Huayao Huang ; Feifei Lin ; Pincang Xia ; Chao Chen ; Zhenyang Zheng ; Sangru Wu ; Hanhan Lei ; Lei Gao ; Mingxu Huang ; Kexu Lin ; Xiaoping Xu ; Yukun Luo ; Ziwen Zhao ; Chen Li ; Hailong Lin ; Yu Lin ; Zhenghui Huang ; Rongxiang Cao ; Limin ChenSource :
- Respiratory research [ 1465-993X ] ; 2020.
English descriptors
- KwdEn :
- Aged (MeSH), Betacoronavirus (pathogenicity), China (epidemiology), Comorbidity (MeSH), Coronavirus Infections (diagnosis), Coronavirus Infections (epidemiology), Coronavirus Infections (virology), Female (MeSH), Host-Pathogen Interactions (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (diagnosis), Pneumonia, Viral (epidemiology), Pneumonia, Viral (virology), Prognosis (MeSH), Retrospective Studies (MeSH), Risk Assessment (MeSH), Risk Factors (MeSH), Severity of Illness Index (MeSH), Time Factors (MeSH), Vascular Diseases (diagnosis), Vascular Diseases (epidemiology).
- MESH :
- geographic , epidemiology : China.
- diagnosis : Coronavirus Infections, Pneumonia, Viral, Vascular Diseases.
- epidemiology : Coronavirus Infections, Pneumonia, Viral, Vascular Diseases.
- pathogenicity : Betacoronavirus.
- virology : Coronavirus Infections, Pneumonia, Viral.
- Aged, Comorbidity, Female, Host-Pathogen Interactions, Humans, Male, Middle Aged, Pandemics, Prognosis, Retrospective Studies, Risk Assessment, Risk Factors, Severity of Illness Index, Time Factors.
Abstract
BACKGROUND
Patients with cardiovascular comorbidities are at high risk of poor outcome from COVID-19. However, how the burden (number) of vascular risk factors influences the risk of severe COVID-19 disease remains unresolved. Our aim was to investigate the association of severe COVID-19 illness with vascular risk factor burden.
METHODS
We included 164 (61.8 ± 13.6 years) patients with COVID-19 in this retrospective study. We compared the difference in clinical characteristics, laboratory findings and chest computed tomography (CT) findings between patients with severe and non-severe COVID-19 illness. We evaluated the association between the number of vascular risk factors and the development of severe COVID-19 disease, using a Cox regression model.
RESULTS
Sixteen (9.8%) patients had no vascular risk factors; 38 (23.2%) had 1; 58 (35.4%) had 2; 34 (20.7%) had 3; and 18 (10.9%) had ≥4 risk factors. Twenty-nine patients (17.7%) experienced severe COVID-19 disease with a median (14 [7-27] days) duration between onset to developing severe COVID-19 disease, an event rate of 4.47 per 1000-patient days (95%CI 3.10-6.43). Kaplan-Meier curves showed a gradual increase in the risk of severe COVID-19 illness (log-rank P < 0.001) stratified by the number of vascular risk factors. After adjustment for age, sex, and comorbidities as potential confounders, vascular risk factor burden remained associated with an increasing risk of severe COVID-19 illness.
CONCLUSIONS
Patients with increasing vascular risk factor burden have an increasing risk of severe COVID-19 disease, and this population might benefit from specific COVID-19 prevention (e.g., self-isolation) and early hospital treatment measures.
DOI: 10.1186/s12931-020-01510-0
PubMed: 32957997
PubMed Central: PMC7503438
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pubmed:32957997Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The effect of vascular risk factor burden on the severity of COVID-19 illness, a retrospective cohort study.</title><author><name sortKey="Du, Houwei" sort="Du, Houwei" uniqKey="Du H" first="Houwei" last="Du">Houwei Du</name><affiliation><nlm:affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China. duhouwei@outlook.com.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China. duhouwei@outlook.com.</nlm:affiliation></affiliation></author><author><name sortKey="Pan, Xiaobin" sort="Pan, Xiaobin" uniqKey="Pan X" first="Xiaobin" last="Pan">Xiaobin Pan</name><affiliation><nlm:affiliation>Department of Critical Care Medicine, Fujian Provincial Hospital South Branch, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Liu, Nan" sort="Liu, Nan" uniqKey="Liu N" first="Nan" last="Liu">Nan Liu</name><affiliation><nlm:affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Junnian" sort="Chen, Junnian" uniqKey="Chen J" first="Junnian" last="Chen">Junnian Chen</name><affiliation><nlm:affiliation>Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Xiaoling" sort="Chen, Xiaoling" uniqKey="Chen X" first="Xiaoling" last="Chen">Xiaoling Chen</name><affiliation><nlm:affiliation>Department of Infectious Disease, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Werring, David J" sort="Werring, David J" uniqKey="Werring D" first="David J" last="Werring">David J. Werring</name><affiliation><nlm:affiliation>UCL Queen Square Institute of Neurology, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Ambler, Gareth" sort="Ambler, Gareth" uniqKey="Ambler G" first="Gareth" last="Ambler">Gareth Ambler</name><affiliation><nlm:affiliation>Statistical Science, University College London, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Li, Xiaoqing" sort="Li, Xiaoqing" uniqKey="Li X" first="Xiaoqing" last="Li">Xiaoqing Li</name><affiliation><nlm:affiliation>Fujian Center for Disease Control and Prevention, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Ronghua" sort="Chen, Ronghua" uniqKey="Chen R" first="Ronghua" last="Chen">Ronghua Chen</name><affiliation><nlm:affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Zhang, Yixian" sort="Zhang, Yixian" uniqKey="Zhang Y" first="Yixian" last="Zhang">Yixian Zhang</name><affiliation><nlm:affiliation>Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Huang, Huayao" sort="Huang, Huayao" uniqKey="Huang H" first="Huayao" last="Huang">Huayao Huang</name><affiliation><nlm:affiliation>Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lin, Feifei" sort="Lin, Feifei" uniqKey="Lin F" first="Feifei" last="Lin">Feifei Lin</name><affiliation><nlm:affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</nlm:affiliation></affiliation></author><author><name sortKey="Xia, Pincang" sort="Xia, Pincang" uniqKey="Xia P" first="Pincang" last="Xia">Pincang Xia</name><affiliation><nlm:affiliation>Fujian Center for Disease Control and Prevention, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Chao" sort="Chen, Chao" uniqKey="Chen C" first="Chao" last="Chen">Chao Chen</name><affiliation><nlm:affiliation>Department of Neurology, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Zheng, Zhenyang" sort="Zheng, Zhenyang" uniqKey="Zheng Z" first="Zhenyang" last="Zheng">Zhenyang Zheng</name><affiliation><nlm:affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Wu, Sangru" sort="Wu, Sangru" uniqKey="Wu S" first="Sangru" last="Wu">Sangru Wu</name><affiliation><nlm:affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lei, Hanhan" sort="Lei, Hanhan" uniqKey="Lei H" first="Hanhan" last="Lei">Hanhan Lei</name><affiliation><nlm:affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</nlm:affiliation></affiliation></author><author><name sortKey="Gao, Lei" sort="Gao, Lei" uniqKey="Gao L" first="Lei" last="Gao">Lei Gao</name><affiliation><nlm:affiliation>Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Huang, Mingxu" sort="Huang, Mingxu" uniqKey="Huang M" first="Mingxu" last="Huang">Mingxu Huang</name><affiliation><nlm:affiliation>Department of Emergency Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lin, Kexu" sort="Lin, Kexu" uniqKey="Lin K" first="Kexu" last="Lin">Kexu Lin</name><affiliation><nlm:affiliation>Department of Emergency Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Xu, Xiaoping" sort="Xu, Xiaoping" uniqKey="Xu X" first="Xiaoping" last="Xu">Xiaoping Xu</name><affiliation><nlm:affiliation>Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Luo, Yukun" sort="Luo, Yukun" uniqKey="Luo Y" first="Yukun" last="Luo">Yukun Luo</name><affiliation><nlm:affiliation>Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Zhao, Ziwen" sort="Zhao, Ziwen" uniqKey="Zhao Z" first="Ziwen" last="Zhao">Ziwen Zhao</name><affiliation><nlm:affiliation>Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Li, Chen" sort="Li, Chen" uniqKey="Li C" first="Chen" last="Li">Chen Li</name><affiliation><nlm:affiliation>Department of Otolaryngology, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lin, Hailong" sort="Lin, Hailong" uniqKey="Lin H" first="Hailong" last="Lin">Hailong Lin</name><affiliation><nlm:affiliation>Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lin, Yu" sort="Lin, Yu" uniqKey="Lin Y" first="Yu" last="Lin">Yu Lin</name><affiliation><nlm:affiliation>Department of Colorectal Surgery, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Huang, Zhenghui" sort="Huang, Zhenghui" uniqKey="Huang Z" first="Zhenghui" last="Huang">Zhenghui Huang</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Cao, Rongxiang" sort="Cao, Rongxiang" uniqKey="Cao R" first="Rongxiang" last="Cao">Rongxiang Cao</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Limin" sort="Chen, Limin" uniqKey="Chen L" first="Limin" last="Chen">Limin Chen</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32957997</idno><idno type="pmid">32957997</idno><idno type="doi">10.1186/s12931-020-01510-0</idno><idno type="pmc">PMC7503438</idno><idno type="wicri:Area/Main/Corpus">000147</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000147</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">The effect of vascular risk factor burden on the severity of COVID-19 illness, a retrospective cohort study.</title><author><name sortKey="Du, Houwei" sort="Du, Houwei" uniqKey="Du H" first="Houwei" last="Du">Houwei Du</name><affiliation><nlm:affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China. duhouwei@outlook.com.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China. duhouwei@outlook.com.</nlm:affiliation></affiliation></author><author><name sortKey="Pan, Xiaobin" sort="Pan, Xiaobin" uniqKey="Pan X" first="Xiaobin" last="Pan">Xiaobin Pan</name><affiliation><nlm:affiliation>Department of Critical Care Medicine, Fujian Provincial Hospital South Branch, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Liu, Nan" sort="Liu, Nan" uniqKey="Liu N" first="Nan" last="Liu">Nan Liu</name><affiliation><nlm:affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Junnian" sort="Chen, Junnian" uniqKey="Chen J" first="Junnian" last="Chen">Junnian Chen</name><affiliation><nlm:affiliation>Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Xiaoling" sort="Chen, Xiaoling" uniqKey="Chen X" first="Xiaoling" last="Chen">Xiaoling Chen</name><affiliation><nlm:affiliation>Department of Infectious Disease, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Werring, David J" sort="Werring, David J" uniqKey="Werring D" first="David J" last="Werring">David J. Werring</name><affiliation><nlm:affiliation>UCL Queen Square Institute of Neurology, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Ambler, Gareth" sort="Ambler, Gareth" uniqKey="Ambler G" first="Gareth" last="Ambler">Gareth Ambler</name><affiliation><nlm:affiliation>Statistical Science, University College London, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Li, Xiaoqing" sort="Li, Xiaoqing" uniqKey="Li X" first="Xiaoqing" last="Li">Xiaoqing Li</name><affiliation><nlm:affiliation>Fujian Center for Disease Control and Prevention, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Ronghua" sort="Chen, Ronghua" uniqKey="Chen R" first="Ronghua" last="Chen">Ronghua Chen</name><affiliation><nlm:affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Zhang, Yixian" sort="Zhang, Yixian" uniqKey="Zhang Y" first="Yixian" last="Zhang">Yixian Zhang</name><affiliation><nlm:affiliation>Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Huang, Huayao" sort="Huang, Huayao" uniqKey="Huang H" first="Huayao" last="Huang">Huayao Huang</name><affiliation><nlm:affiliation>Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lin, Feifei" sort="Lin, Feifei" uniqKey="Lin F" first="Feifei" last="Lin">Feifei Lin</name><affiliation><nlm:affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</nlm:affiliation></affiliation></author><author><name sortKey="Xia, Pincang" sort="Xia, Pincang" uniqKey="Xia P" first="Pincang" last="Xia">Pincang Xia</name><affiliation><nlm:affiliation>Fujian Center for Disease Control and Prevention, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Chao" sort="Chen, Chao" uniqKey="Chen C" first="Chao" last="Chen">Chao Chen</name><affiliation><nlm:affiliation>Department of Neurology, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Zheng, Zhenyang" sort="Zheng, Zhenyang" uniqKey="Zheng Z" first="Zhenyang" last="Zheng">Zhenyang Zheng</name><affiliation><nlm:affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Wu, Sangru" sort="Wu, Sangru" uniqKey="Wu S" first="Sangru" last="Wu">Sangru Wu</name><affiliation><nlm:affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lei, Hanhan" sort="Lei, Hanhan" uniqKey="Lei H" first="Hanhan" last="Lei">Hanhan Lei</name><affiliation><nlm:affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</nlm:affiliation></affiliation></author><author><name sortKey="Gao, Lei" sort="Gao, Lei" uniqKey="Gao L" first="Lei" last="Gao">Lei Gao</name><affiliation><nlm:affiliation>Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Huang, Mingxu" sort="Huang, Mingxu" uniqKey="Huang M" first="Mingxu" last="Huang">Mingxu Huang</name><affiliation><nlm:affiliation>Department of Emergency Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lin, Kexu" sort="Lin, Kexu" uniqKey="Lin K" first="Kexu" last="Lin">Kexu Lin</name><affiliation><nlm:affiliation>Department of Emergency Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Xu, Xiaoping" sort="Xu, Xiaoping" uniqKey="Xu X" first="Xiaoping" last="Xu">Xiaoping Xu</name><affiliation><nlm:affiliation>Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Luo, Yukun" sort="Luo, Yukun" uniqKey="Luo Y" first="Yukun" last="Luo">Yukun Luo</name><affiliation><nlm:affiliation>Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Zhao, Ziwen" sort="Zhao, Ziwen" uniqKey="Zhao Z" first="Ziwen" last="Zhao">Ziwen Zhao</name><affiliation><nlm:affiliation>Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Li, Chen" sort="Li, Chen" uniqKey="Li C" first="Chen" last="Li">Chen Li</name><affiliation><nlm:affiliation>Department of Otolaryngology, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lin, Hailong" sort="Lin, Hailong" uniqKey="Lin H" first="Hailong" last="Lin">Hailong Lin</name><affiliation><nlm:affiliation>Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lin, Yu" sort="Lin, Yu" uniqKey="Lin Y" first="Yu" last="Lin">Yu Lin</name><affiliation><nlm:affiliation>Department of Colorectal Surgery, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Huang, Zhenghui" sort="Huang, Zhenghui" uniqKey="Huang Z" first="Zhenghui" last="Huang">Zhenghui Huang</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Cao, Rongxiang" sort="Cao, Rongxiang" uniqKey="Cao R" first="Rongxiang" last="Cao">Rongxiang Cao</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Limin" sort="Chen, Limin" uniqKey="Chen L" first="Limin" last="Chen">Limin Chen</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Respiratory research</title><idno type="eISSN">1465-993X</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Betacoronavirus (pathogenicity)</term><term>China (epidemiology)</term><term>Comorbidity (MeSH)</term><term>Coronavirus Infections (diagnosis)</term><term>Coronavirus Infections (epidemiology)</term><term>Coronavirus Infections (virology)</term><term>Female (MeSH)</term><term>Host-Pathogen Interactions (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (diagnosis)</term><term>Pneumonia, Viral (epidemiology)</term><term>Pneumonia, Viral (virology)</term><term>Prognosis (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>Risk Assessment (MeSH)</term><term>Risk Factors (MeSH)</term><term>Severity of Illness Index (MeSH)</term><term>Time Factors (MeSH)</term><term>Vascular Diseases (diagnosis)</term><term>Vascular Diseases (epidemiology)</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>China</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term><term>Vascular Diseases</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term><term>Vascular Diseases</term></keywords><keywords scheme="MESH" qualifier="pathogenicity" xml:lang="en"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Comorbidity</term><term>Female</term><term>Host-Pathogen Interactions</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>Prognosis</term><term>Retrospective Studies</term><term>Risk Assessment</term><term>Risk Factors</term><term>Severity of Illness Index</term><term>Time Factors</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Patients with cardiovascular comorbidities are at high risk of poor outcome from COVID-19. However, how the burden (number) of vascular risk factors influences the risk of severe COVID-19 disease remains unresolved. Our aim was to investigate the association of severe COVID-19 illness with vascular risk factor burden.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We included 164 (61.8 ± 13.6 years) patients with COVID-19 in this retrospective study. We compared the difference in clinical characteristics, laboratory findings and chest computed tomography (CT) findings between patients with severe and non-severe COVID-19 illness. We evaluated the association between the number of vascular risk factors and the development of severe COVID-19 disease, using a Cox regression model.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Sixteen (9.8%) patients had no vascular risk factors; 38 (23.2%) had 1; 58 (35.4%) had 2; 34 (20.7%) had 3; and 18 (10.9%) had ≥4 risk factors. Twenty-nine patients (17.7%) experienced severe COVID-19 disease with a median (14 [7-27] days) duration between onset to developing severe COVID-19 disease, an event rate of 4.47 per 1000-patient days (95%CI 3.10-6.43). Kaplan-Meier curves showed a gradual increase in the risk of severe COVID-19 illness (log-rank P < 0.001) stratified by the number of vascular risk factors. After adjustment for age, sex, and comorbidities as potential confounders, vascular risk factor burden remained associated with an increasing risk of severe COVID-19 illness.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Patients with increasing vascular risk factor burden have an increasing risk of severe COVID-19 disease, and this population might benefit from specific COVID-19 prevention (e.g., self-isolation) and early hospital treatment measures.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32957997</PMID><DateCompleted><Year>2020</Year><Month>09</Month><Day>23</Day></DateCompleted><DateRevised><Year>2020</Year><Month>10</Month><Day>01</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1465-993X</ISSN><JournalIssue CitedMedium="Internet"><Volume>21</Volume><Issue>1</Issue><PubDate><Year>2020</Year><Month>Sep</Month><Day>21</Day></PubDate></JournalIssue><Title>Respiratory research</Title><ISOAbbreviation>Respir Res</ISOAbbreviation></Journal><ArticleTitle>The effect of vascular risk factor burden on the severity of COVID-19 illness, a retrospective cohort study.</ArticleTitle><Pagination><MedlinePgn>241</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s12931-020-01510-0</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Patients with cardiovascular comorbidities are at high risk of poor outcome from COVID-19. However, how the burden (number) of vascular risk factors influences the risk of severe COVID-19 disease remains unresolved. Our aim was to investigate the association of severe COVID-19 illness with vascular risk factor burden.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We included 164 (61.8 ± 13.6 years) patients with COVID-19 in this retrospective study. We compared the difference in clinical characteristics, laboratory findings and chest computed tomography (CT) findings between patients with severe and non-severe COVID-19 illness. We evaluated the association between the number of vascular risk factors and the development of severe COVID-19 disease, using a Cox regression model.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Sixteen (9.8%) patients had no vascular risk factors; 38 (23.2%) had 1; 58 (35.4%) had 2; 34 (20.7%) had 3; and 18 (10.9%) had ≥4 risk factors. Twenty-nine patients (17.7%) experienced severe COVID-19 disease with a median (14 [7-27] days) duration between onset to developing severe COVID-19 disease, an event rate of 4.47 per 1000-patient days (95%CI 3.10-6.43). Kaplan-Meier curves showed a gradual increase in the risk of severe COVID-19 illness (log-rank P < 0.001) stratified by the number of vascular risk factors. After adjustment for age, sex, and comorbidities as potential confounders, vascular risk factor burden remained associated with an increasing risk of severe COVID-19 illness.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Patients with increasing vascular risk factor burden have an increasing risk of severe COVID-19 disease, and this population might benefit from specific COVID-19 prevention (e.g., self-isolation) and early hospital treatment measures.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Du</LastName><ForeName>Houwei</ForeName><Initials>H</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-5978-9734</Identifier><AffiliationInfo><Affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China. duhouwei@outlook.com.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China. duhouwei@outlook.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pan</LastName><ForeName>Xiaobin</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Department of Critical Care Medicine, Fujian Provincial Hospital South Branch, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liu</LastName><ForeName>Nan</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Junnian</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Xiaoling</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Department of Infectious Disease, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Werring</LastName><ForeName>David J</ForeName><Initials>DJ</Initials><AffiliationInfo><Affiliation>UCL Queen Square Institute of Neurology, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ambler</LastName><ForeName>Gareth</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Statistical Science, University College London, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Xiaoqing</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Fujian Center for Disease Control and Prevention, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Ronghua</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhang</LastName><ForeName>Yixian</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Huang</LastName><ForeName>Huayao</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lin</LastName><ForeName>Feifei</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Xia</LastName><ForeName>Pincang</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Fujian Center for Disease Control and Prevention, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Chao</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Neurology, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zheng</LastName><ForeName>Zhenyang</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wu</LastName><ForeName>Sangru</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lei</LastName><ForeName>Hanhan</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Stroke Research Center, Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gao</LastName><ForeName>Lei</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Huang</LastName><ForeName>Mingxu</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Emergency Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lin</LastName><ForeName>Kexu</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Emergency Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Xu</LastName><ForeName>Xiaoping</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Luo</LastName><ForeName>Yukun</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhao</LastName><ForeName>Ziwen</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Chen</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Otolaryngology, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lin</LastName><ForeName>Hailong</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lin</LastName><ForeName>Yu</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Colorectal Surgery, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Huang</LastName><ForeName>Zhenghui</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Department of Respiratory Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cao</LastName><ForeName>Rongxiang</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Respiratory Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Limin</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Respiratory Medicine, Fujian Medical University Union Hospital, Fuzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>Fujian Medical Team Support Wuhan for COVID-19</CollectiveName></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>2016B014</GrantID><Agency>Fujian Provincial Special Foundation for Natural Science Innovation Project</Agency><Country></Country></Grant><Grant><GrantID>2019Y9099</GrantID><Agency>the Joint Funds for the Innovation of Science and Technology, Fujian Province</Agency><Country></Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D064888">Observational Study</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>09</Month><Day>21</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Respir Res</MedlineTA><NlmUniqueID>101090633</NlmUniqueID><ISSNLinking>1465-9921</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName><QualifierName UI="Q000472" MajorTopicYN="N">pathogenicity</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002681" MajorTopicYN="N" Type="Geographic">China</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015897" MajorTopicYN="N">Comorbidity</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D054884" MajorTopicYN="N">Host-Pathogen Interactions</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011379" MajorTopicYN="N">Prognosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018570" MajorTopicYN="N">Risk Assessment</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014652" MajorTopicYN="N">Vascular Diseases</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Coronavirus disease 2019</Keyword><Keyword MajorTopicYN="N">Prognosis</Keyword><Keyword MajorTopicYN="N">Vascular risk factor</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>07</Month><Day>23</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>09</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>22</Day><Hour>5</Hour><Minute>30</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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