Risks Factors for Death among COVID-19 Patients Combined with Hypertension, Coronary Heart Disease or Diabetes/ 合并高血压、冠心病、糖尿病的新型冠状病毒肺炎患者发生病死的危险因素分析

Objective: The pathogenesis of myocardial injury upon corona virus disease 2019 (COVID-19) infection remain unknown，evidence of impact on outcome is insufficient, therefore, we aim to investigate the risk factors for death among COVID-19 patients combined with hypertension, coronary heart disease or diabetes in this study Methods: This was a single-centered, retrospective, observational study Patients of Sino-French Eco-City section of Tongji Hospital, Wuhan, China attended by Peking University Supporting Medical Team and admitted from Jan 29, 2020 to Mar 20, 2020 were included The positive nucleic acid of COVID-19 virus and combined with hypertension, coronary heart disease or diabetes were in the standard We collected the clinical data and laboratory examination results of eligible patients to evaluate the related factors of death Results: In the study, 94 COVID-19 patients enrolled are divided into the group of death (13 cases) and the group of survivors (81 cases), the average age was 66 7 years old Compared with the survival group, the death group had faster basal heart rate（103 2 beats/min vs 88 4 beats /min, P=0 004）, shortness of breath（29 0 bea s /min vs 20 0 beats /min, P<0 001）, higher neutrophil count（9 2×109/L vs 3 8×109/L, P <0 001）, lower lymphocyte count（0 5×109/L vs 1 1×109/L, P <0 001）, creatine kinase MB（CK-MB, 3 2 μg/L vs 0 8 μg/L, P <0 001）, high sensitivity cardiac troponin I（hscTnI, 217 2 ng/L vs 4 9 ng/L, P <0 001）, N-terminal pro Brain Natriuretic Peptide（NT-proBNP,945 0 μg/L vs 154 0 μg/L, P <0 001）, inflammatory factor ferritin（770 2 μg/L vs 622 8 μg/L , P =0 050）, interleukin-2 recepter（IL-2R, 1 586 0 U/mL vs 694 0 U/mL, P <0 001）, interleukin- 6（IL-6, 82 3 ng/L vs 13 0 ng/L, P <0 001）, interleukin-10（IL-10, 9 8 ng/L vs 5 0 ng/L, P<0 001）were higher than those in the survival group Univariate logistic regression analysis showed that the risk factors for death were old age, low non oxygen saturation, low lymphocyte count, myocardial injury, abnormal increase of IL 2r, IL-6, IL-10 Multivariate regression showed that old age （OR=1 11, 95%CI =1 03-1 19, P =0 026）、low non oxygen saturation（OR=0 85, 95% CI =0 72-0 99, P =0 041）、abnormal increase of IL-10（＞9 1 ng/L, OR=101 93, 95%CI =4 74-2190 71, P =0 003）were independent risk factors for COVID-19 patients combined with hypertension, coronary heart disease or diabetes Conclusion: In COVID-19 patients combined with hypertension, coronary heart disease or diabetes, the risk factors for death were old age, low non oxygen saturation, low lymphocyte count, myocardial injury Abnormal increase of IL-2R, IL-6, IL-10 Old age, low non oxygen saturation and abnormal increase of IL-10 were independent risk factors