美国成年人在 SARS-CoV-2 大流行期间的心血管代谢疾病的真实世界数据：一项去中心化注册研究。

Real world data on cardiometabolic diseases in U.S. adults during the SARS-CoV-2 pandemic: a decentralized registry study.

机构信息

ObvioHealth, 3452 Lake Lynda Dr., Bld. 100 Ste 151, Orlando, FL, 32832, USA.

出版信息

Cardiovasc Diabetol. 2022 Feb 14;21(1):24. doi: 10.1186/s12933-022-01462-3.

DOI:10.1186/s12933-022-01462-3

PMID:35164745

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8845313/

Abstract

BACKGROUND

Pre-existing cardiometabolic comorbidities place SARS-CoV-2 positive patients at a greater risk for poorer clinical course and mortality than those without it. We aimed to analyze real-world registry data focused primarily on participants with cardiometabolic diseases (CMD), which were remotely obtained via a digital platform.

METHODS

Participants were divided into two groups: CMD or no cardiometabolic disease (non-CMD). They were evaluated based on their medical history, current medications/supplements, COVID-19 status, demographics, and baseline characteristics. The frequency of medications/supplements for CMD were compared using relative risks and 95% confidence intervals. The WHO (Five) Well-Being Index (WHO-5) were collected monthly for 6 months to assess psychological well-being which included cheerfulness, calmness, vigor, rest, and engagement with daily activities of interest.

RESULTS

The 791 enrollees represented 49 U.S. states. The CMD group had significantly higher (p < 0.0001) BMI (mean + 3.04 kg/m) and age (mean + 9.15 years) compared to non-CMD group. In the CMD group, participants who tested positive for COVID-19 had lower (p < 0.0001) well-being scores than those without COVID-19. For the 274 participants on CMD medications/supplements, there was no statistical difference in risk of COVID-19 contracture based on medication/supplement type; however, all six participants who were not being treated for CMD were COVID-19 positive (RR ~ 104). For 89 participants who were on treatment for diabetes or insulin resistance, there was a 90% reduced risk of COVID-19 incidence (p = 0.0187).

CONCLUSION

The well-being score of the CMD group was dependent on whether they tested positive for COVID-19. Type of CMD treatment did not impact COVID-19 status, but absence of treatment significantly increased COVID-19 incidence. With respect to SARS-CoV-2, our analysis supports continued use of the statins, ACE-I, ARBs, and diabetes medications in CMD patients.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04348942.

摘要

背景

与没有合并症的患者相比，合并心血管代谢合并症的 SARS-CoV-2 阳性患者临床预后和死亡率更差。我们旨在分析主要针对心血管代谢疾病（CMD）患者的真实世界登记数据，这些数据是通过数字平台远程获得的。

方法

参与者分为两组：CMD 或无心血管代谢疾病（非 CMD）。根据他们的病史、当前药物/补充剂、COVID-19 状态、人口统计学和基线特征进行评估。使用相对风险和 95%置信区间比较 CMD 药物/补充剂的使用频率。每月收集 6 个月的世界卫生组织（五）幸福感指数（WHO-5），以评估心理健康，包括愉快、平静、活力、休息和参与感兴趣的日常活动。

结果

791 名参与者代表美国 49 个州。CMD 组的 BMI（平均+3.04kg/m）和年龄（平均+9.15 岁）明显高于非 CMD 组（p<0.0001）。在 CMD 组中，COVID-19 检测呈阳性的参与者的幸福感评分明显低于未感染 COVID-19 的参与者（p<0.0001）。对于 274 名服用 CMD 药物/补充剂的参与者，根据药物/补充剂类型，COVID-19 感染的风险没有统计学差异；然而，所有 6 名未接受 CMD 治疗的参与者均 COVID-19 检测呈阳性（RR~104）。对于 89 名接受糖尿病或胰岛素抵抗治疗的参与者，COVID-19 发病风险降低了 90%（p=0.0187）。