{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T07:17:36Z","timestamp":1772176656744,"version":"3.50.1"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background &amp; objectives<\/jats:title>\n                    <jats:p>Presence of cardiovascular (CV) risk factors enhance adverse outcomes in COVID-19. To determine association of risk factors with clinical outcomes in India we performed a study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Successive virologically confirmed adult patients of COVID-19 at a government hospital were recruited at admission and data on clinical presentation and in-hospital outcomes were obtained. The cohort was classified according to age, sex, hypertension, diabetes and tobacco use. In-hospital death was the primary outcome. Logistic regression was performed to compared outcomes in different groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From April to September 2020 we recruited 4645 (men 3386, women 1259) out of 5103 virologically confirmed COVID-19 patients (91.0%). Mean age was 46\u00b118y, hypertension was in 17.8%, diabetes in 16.6% and any tobacco-use in 29.5%. Duration of hospital stay was 6.8\u00b13.7 days, supplemental oxygen was in 18.4%, non-invasive ventilation in 7.1%, mechanical ventilation in 3.6% and 7.3% died. Unadjusted and age-sex adjusted odds ratio(OR) and 95% confidence intervals(CI) for in-hospital mortality, respectively, were: age \u226560y vs &lt;40y, OR 8.47(95% CI 5.87\u201312.21) and 8.49(5.88\u201312.25), age 40-59y vs &lt;40y 3.69(2.53\u20135.38) and 3.66(2.50\u20135.33), men vs women 1.88(1.41\u20132.51) and 1.26(0.91\u20131.48); hypertension 2.22(1.74\u20132.83) and 1.32(1.02\u20131.70), diabetes 1.88(1.46\u20132.43) and 1.16(0.89\u20131.52); and tobacco 1.29(1.02\u20131.63) and 1.28(1.00\u20131.63). Need for invasive and non-invasive ventilation was greater among patients in age-groups 40\u201349 and \u226560y and hypertension. Multivariate adjustment for social factors, clinical features and biochemical tests attenuated significance of all risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cardiovascular risk factors, age, male sex, hypertension, diabetes and tobacco-use, are associated with greater risk of in-hospital death among COVID-19 patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pgph.0000234","type":"journal-article","created":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T13:23:08Z","timestamp":1648819388000},"page":"e0000234","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cardiovascular risk factors and outcomes in COVID-19: A hospital-based study in India"],"prefix":"10.1371","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1357-4831","authenticated-orcid":true,"given":"Arvind K.","family":"Sharma","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6166-7787","authenticated-orcid":true,"given":"Vaseem Naheed","family":"Baig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5514-1618","authenticated-orcid":true,"given":"Sonali","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaurav","family":"Dalela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raja Babu","family":"Panwar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0845-2354","authenticated-orcid":true,"given":"Vishwa Mohan","family":"Katoch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8356-3137","authenticated-orcid":true,"given":"Rajeev","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,4,1]]},"reference":[{"key":"pgph.0000234.ref001","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1038\/s41569-020-0413-9","article-title":"COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives","author":"M Nishiga","year":"2020","journal-title":"Nature Rev Cardiol"},{"key":"pgph.0000234.ref002","doi-asserted-by":"crossref","first-page":"64","DOI":"10.5334\/gh.814","article-title":"The relationship of COVID-19 severity with cardiovascular disease and its traditional risk factors: a systematic review and meta-analysis","volume":"15","author":"K Matsushita","year":"2020","journal-title":"Global Heart"},{"key":"pgph.0000234.ref003","doi-asserted-by":"crossref","first-page":"0241541","DOI":"10.1371\/journal.pone.0241541","article-title":"Factors associated with disease severity and mortality among patients with COVID-19: a systematic review and meta-analysis.","volume":"15","author":"V Chidambaram","year":"2020","journal-title":"PLoS One"},{"key":"pgph.0000234.ref004","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s12872-020-01816-3","article-title":"Cardiovascular risk factors and mortality in hospitalized patients with COVID-19: a systematic review and meta-analysis of 45 studies and 18300 patients","volume":"21","author":"A Silverio","year":"2021","journal-title":"BMC Cardiovasc Disord"},{"key":"pgph.0000234.ref005","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1136\/heartjnl-2020-317901","article-title":"Impact of cardiovascular disease and risk factors on fatal outcomes in patients with COVID-19 according to age: a systematic review and meta-analysis","volume":"107","author":"SA Bae","year":"2021","journal-title":"Heart"},{"key":"pgph.0000234.ref006","doi-asserted-by":"crossref","first-page":"045482","DOI":"10.1136\/bmjopen-2020-045482","article-title":"Cardiovascular risk factors and COVID-19 outcomes in hospitalized patients: a prospective cohort study","volume":"11","author":"D Collard","year":"2021","journal-title":"BMJ Open"},{"key":"pgph.0000234.ref007","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/S2213-8587(21)00089-9","article-title":"Associations between body mass index and COVID-19 severity in 6.9 million people in England: a prospective, community-based, cohort study","volume":"9","author":"M Gao","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"key":"pgph.0000234.ref008","author":"H Ritchie","year":"2022","journal-title":"Coronavirus pandemic (COVID-19)."},{"key":"pgph.0000234.ref009","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global burden of cardiovascular diseases and risk factors, 1990\u20132019: Update from the Global Burden of Disease 2019 Study.","volume":"76","author":"Global Burden of Diseases CVD Collaborators","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"pgph.0000234.ref010","article-title":"India: Coronavirus Pandemic Country Profile.","author":"H Ritchie","year":"2022"},{"key":"pgph.0000234.ref011","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.1111\/dom.14124","article-title":"Prevalence of co-morbidities and their association with mortality in patients with COVID-19: a systematic review and meta-analysis","volume":"22","author":"AK Singh","year":"2020","journal-title":"Diabetes Obes Metab"},{"key":"pgph.0000234.ref012","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1016\/j.dsx.2020.06.064","article-title":"Coronavirus disease (COVID-19): a systematic review and meta-analysis to evaluate the impact of various comorbidities and serious events.","volume":"14","author":"K Nandy","year":"2020","journal-title":"Diabetes Metab Syndr"},{"key":"pgph.0000234.ref013","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1007\/s00392-020-01720-y","article-title":"Interplay of COVID-10 and cardiovascular diseases in Africa: an observational snapshot","volume":"109","author":"G Chakafana","year":"2020","journal-title":"Clin Res Cardiol"},{"key":"pgph.0000234.ref014","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.dsx.2021.01.005","article-title":"Macrolevel association of COVID-19 with non-communicable disease risk factors in India.","volume":"15","author":"K Gaur","year":"2021","journal-title":"Diabetes Metab Syndr"},{"issue":"8","key":"pgph.0000234.ref015","first-page":"62","article-title":"Characteristics and outcomes of hospitalized young adults with mild to moderate COVID-19 at a university hospital in India.","volume":"68","author":"AK Sharma","year":"2020","journal-title":"J Assoc Physicians India"},{"issue":"6","key":"pgph.0000234.ref016","first-page":"86","article-title":"Association of SARS CoV-2 cycle threshold (Ct) with clinical outcomes: a hospital-based study.","volume":"69","author":"S Sharma","year":"2021","journal-title":"J Assoc Physicians India."},{"key":"pgph.0000234.ref017","article-title":"Educational status and COVID-19 related outcomes in India: Hospital-based cross-sectional study","author":"AK Sharma","year":"2022","journal-title":"BMJ Open"},{"key":"pgph.0000234.ref018","unstructured":"Government of India, Ministry of Health and Family Welfare. Clinical management protocol: COVID-19. Available at: http:\/\/www.rajswasthya.nic.in\/PDF\/COVID%20-19\/FOR%20HOSPITALS\/27.06.2020.pdf. Accessed 30 April 2021."},{"key":"pgph.0000234.ref019","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1038\/s41371-018-0117-3","article-title":"Emerging trends in hypertension epidemiology in India.","volume":"33","author":"R Gupta","year":"2019","journal-title":"J Human Hypertens"},{"key":"pgph.0000234.ref020","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1161\/CIRCRESAHA.121.318054","article-title":"Hypertension, a moving target in COVID-19: current views and perspectives","volume":"128","author":"C Savoia","year":"2021","journal-title":"Circ Res"},{"key":"pgph.0000234.ref021","doi-asserted-by":"crossref","first-page":"599729","DOI":"10.3389\/fphys.2020.599729","article-title":"Biological context linking hypertension and higher risk for COVID-19 severity.","volume":"11","author":"CAM Tavares","year":"2020","journal-title":"Front Physiol."},{"key":"pgph.0000234.ref022","doi-asserted-by":"crossref","first-page":"e000048","DOI":"10.1136\/bmjdrc-2014-000048","article-title":"Prevalence of diabetes and cardiovascular risk factors in middle-class urban populations in India.","volume":"2","author":"A Gupta","year":"2014","journal-title":"BMJ Open Diabetes Res Care"},{"key":"pgph.0000234.ref023","doi-asserted-by":"crossref","first-page":"e0243191","DOI":"10.1371\/journal.pone.0243191","article-title":"Prevalence and predictors of death and severe disease in patients hospitalized due to COVID-19: a comprehensive systematic review and meta-analysis of 77 studies and 38,000 patients.","volume":"15","author":"K Dorjee","year":"2020","journal-title":"PLoS One."},{"key":"pgph.0000234.ref024","doi-asserted-by":"crossref","first-page":"101313","DOI":"10.1016\/j.eujim.2021.101313","article-title":"Association of smoking history with severe and critical outcomes in COVID-19 patients: a systematic review and meta-analysis.","volume":"43","author":"H Zhang","year":"2021","journal-title":"Eur J Intergr Med"},{"key":"pgph.0000234.ref025","doi-asserted-by":"crossref","first-page":"e100620186664","DOI":"10.2174\/1573399816666201006144606","article-title":"Epidemiology of ischemic heart disease and diabetes in India: An overview of the twin epidemic","volume":"17","author":"R Gupta","year":"2020","journal-title":"Current Diabetes Reviews"},{"key":"pgph.0000234.ref026","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/j.chest.2021.04.004","article-title":"The usefulness of chest CT imaging in patients with suspected or diagnosed COVID-19: a review of literature.","volume":"160","author":"S Machnicki","year":"2021","journal-title":"Chest"},{"key":"pgph.0000234.ref027","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1038\/s41591-021-01283-z","article-title":"Post-acute COVID-19 syndrome","volume":"27","author":"A Nalbandian","year":"2021","journal-title":"Nature Med"},{"key":"pgph.0000234.ref028","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1016\/S1473-3099(20)30457-6","article-title":"Effectiveness of isolation, testing, contact tracing, and physical distancing on reducing transmission of SARS-CoV-2 in different settings: a mathematical modelling study","volume":"20","author":"A Kucharski","year":"2020","journal-title":"Lancet Infect Dis"},{"key":"pgph.0000234.ref029","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1038\/s41591-021-01379-6","article-title":"Equitable allocation of COVID-19 vaccines in the United States","volume":"27","author":"H Schmidt","year":"2021","journal-title":"Nature Med"},{"key":"pgph.0000234.ref030","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1038\/s41371-020-0387-4","article-title":"COVID-19 and the cardiovascular system: a comprehensive review.","volume":"35","author":"RB Azevodo","year":"2021","journal-title":"J Human Hypertens."},{"key":"pgph.0000234.ref031","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1038\/s41591-020-0968-3","article-title":"Extrapulmonary manifestations of COVID-19","volume":"26","author":"A Gupta","year":"2020","journal-title":"Nature Med"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0000234","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T13:23:44Z","timestamp":1648819424000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0000234"}},"subtitle":[],"editor":[{"given":"Manish","family":"Barman","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,4,1]]},"references-count":31,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4,1]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0000234","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2021.09.19.21263788","asserted-by":"object"}]},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,1]]}}}