COVID-19 associated mortality and cardiovascular disease outcomes among US women veterans

Abstract The burden of COVID-19 has been noted to be disproportionately greater in minority women, a population that is nevertheless still understudied in COVID-19 research. We conducted an observational study to examine COVID-19-associated mortality and cardiovascular disease outcomes after testing...

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Autores principales:	Shirling Tsai, Hang Nguyen, Ramin Ebrahimi, Monica R. Barbosa, Bala Ramanan, Daniel F. Heitjan, Jeffrey L. Hastings, J. Gregory Modrall, Haekyung Jeon-Slaughter
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b306875201be43d4bfd324f51570a685
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spelling	oai:doaj.org-article:b306875201be43d4bfd324f51570a6852021-12-02T17:32:57ZCOVID-19 associated mortality and cardiovascular disease outcomes among US women veterans10.1038/s41598-021-88111-z2045-2322https://doaj.org/article/b306875201be43d4bfd324f51570a6852021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-88111-zhttps://doaj.org/toc/2045-2322Abstract The burden of COVID-19 has been noted to be disproportionately greater in minority women, a population that is nevertheless still understudied in COVID-19 research. We conducted an observational study to examine COVID-19-associated mortality and cardiovascular disease outcomes after testing (henceforth index) among a racially diverse adult women veteran population. We assembled a retrospective cohort from a Veterans Affairs (VA) national COVID-19 shared data repository, collected between February and August 2020. A case was defined as a woman veteran who tested positive for SARS-COV-2, and a control as a woman veteran who tested negative. We used Kaplan–Meier curves and the Cox proportional hazards model to examine the distribution of time to death and the effects of baseline predictors on mortality risk. We used generalized linear models to examine 60-day cardiovascular disease outcomes. Covariates studied included age, body mass index (BMI), and active smoking status at index, and pre-existing conditions of diabetes, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), and a history of treatment with antiplatelet or anti-thrombotic drug at any time in the 2 years prior to the index date. Women veterans who tested positive for SARS-CoV-2 had 4 times higher mortality risk than women veterans who tested negative (Hazard Ratio 3.8, 95% Confidence Interval CI 2.92 to 4.89) but had lower risk of cardiovascular events (Odds Ratio OR 0.78, 95% CI 0.66 to 0.92) and developing new heart disease conditions within 60 days (OR 0.67, 95% CI 0.58 to 0.77). Older age, obesity (BMI > 30), and prior CVD and COPD conditions were positively associated with increased mortality in 60 days. Despite a higher infection rate among minority women veterans, there was no significant race difference in mortality, cardiovascular events, or onset of heart disease. SARS-CoV-2 infection increased short-term mortality risk among women veterans similarly across race groups. However, there was no evidence of increased cardiovascular disease incidence in 60 days. A longer follow-up of women veterans who tested positive is warranted.Shirling TsaiHang NguyenRamin EbrahimiMonica R. BarbosaBala RamananDaniel F. HeitjanJeffrey L. HastingsJ. Gregory ModrallHaekyung Jeon-SlaughterNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Shirling Tsai Hang Nguyen Ramin Ebrahimi Monica R. Barbosa Bala Ramanan Daniel F. Heitjan Jeffrey L. Hastings J. Gregory Modrall Haekyung Jeon-Slaughter COVID-19 associated mortality and cardiovascular disease outcomes among US women veterans
description	Abstract The burden of COVID-19 has been noted to be disproportionately greater in minority women, a population that is nevertheless still understudied in COVID-19 research. We conducted an observational study to examine COVID-19-associated mortality and cardiovascular disease outcomes after testing (henceforth index) among a racially diverse adult women veteran population. We assembled a retrospective cohort from a Veterans Affairs (VA) national COVID-19 shared data repository, collected between February and August 2020. A case was defined as a woman veteran who tested positive for SARS-COV-2, and a control as a woman veteran who tested negative. We used Kaplan–Meier curves and the Cox proportional hazards model to examine the distribution of time to death and the effects of baseline predictors on mortality risk. We used generalized linear models to examine 60-day cardiovascular disease outcomes. Covariates studied included age, body mass index (BMI), and active smoking status at index, and pre-existing conditions of diabetes, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), and a history of treatment with antiplatelet or anti-thrombotic drug at any time in the 2 years prior to the index date. Women veterans who tested positive for SARS-CoV-2 had 4 times higher mortality risk than women veterans who tested negative (Hazard Ratio 3.8, 95% Confidence Interval CI 2.92 to 4.89) but had lower risk of cardiovascular events (Odds Ratio OR 0.78, 95% CI 0.66 to 0.92) and developing new heart disease conditions within 60 days (OR 0.67, 95% CI 0.58 to 0.77). Older age, obesity (BMI > 30), and prior CVD and COPD conditions were positively associated with increased mortality in 60 days. Despite a higher infection rate among minority women veterans, there was no significant race difference in mortality, cardiovascular events, or onset of heart disease. SARS-CoV-2 infection increased short-term mortality risk among women veterans similarly across race groups. However, there was no evidence of increased cardiovascular disease incidence in 60 days. A longer follow-up of women veterans who tested positive is warranted.
format	article
author	Shirling Tsai Hang Nguyen Ramin Ebrahimi Monica R. Barbosa Bala Ramanan Daniel F. Heitjan Jeffrey L. Hastings J. Gregory Modrall Haekyung Jeon-Slaughter
author_facet	Shirling Tsai Hang Nguyen Ramin Ebrahimi Monica R. Barbosa Bala Ramanan Daniel F. Heitjan Jeffrey L. Hastings J. Gregory Modrall Haekyung Jeon-Slaughter
author_sort	Shirling Tsai
title	COVID-19 associated mortality and cardiovascular disease outcomes among US women veterans
title_short	COVID-19 associated mortality and cardiovascular disease outcomes among US women veterans
title_full	COVID-19 associated mortality and cardiovascular disease outcomes among US women veterans
title_fullStr	COVID-19 associated mortality and cardiovascular disease outcomes among US women veterans
title_full_unstemmed	COVID-19 associated mortality and cardiovascular disease outcomes among US women veterans
title_sort	covid-19 associated mortality and cardiovascular disease outcomes among us women veterans
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/b306875201be43d4bfd324f51570a685
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COVID-19 associated mortality and cardiovascular disease outcomes among US women veterans

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