Effect of Pre-existing Ischemic Heart Disease on 30-Days Mortality in COVID-19 Patients

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Abstract Background: COVID-19 has emerged as a multisystem inflammatory disorder with significant cardiovascular implications. Patients with pre-existing cardiovascular conditions may be particularly vulnerable to severe outcomes, yet data from developing countries regarding the impact of pre-existing ischemic heart disease (IHD) on COVID-19 outcomes remains limited. Objective: To investigate the effect of pre-existing ischemic heart disease on 30-day mortality in COVID-19 patients at a tertiary care hospital in Bangladesh. Methods: This case-control study was conducted at Dhaka Medical College Hospital over twelve months, enrolling 120 RT-PCR-confirmed COVID-19 patients (60 with pre-existing IHD, 60 without IHD). Clinical characteristics, laboratory parameters, and treatment modalities were assessed. Outcomes included in-hospital mortality, complications, and 30-day mortality. Data analysis included chi-square tests, t-tests, and multivariable logistic regression. Results: COVID-19 patients with pre-existing IHD showed significantly higher rates of critical disease (30.0% vs 11.6%, p=0.002), cardiac complications including acute myocardial infarction (45.0% vs 0%, p=0.001), and heart failure (28.3% vs 6.66%, p=0.001). The IHD group required more intensive care (71.6% vs 36.6%, p<0.001) and demonstrated higher in-hospital mortality (36.6% vs 10%, p<0.001) and 30-day mortality (60.0% vs 16.6%, p<0.001). After adjusting for confounders, pre-existing IHD independently predicted 30-day mortality (OR=7.25, 95% CI=2.17-24.23). Conclusion: COVID-19 patients with pre-existing IHD experience significantly worse outcomes, including higher rates of complications and mortality. These findings emphasize the need for enhanced monitoring and aggressive management strategies for COVID-19 patients with pre-existing IHD in Bangladesh.

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