University of Leicester
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Impact of cardiometabolic multimorbidity and ethnicity on cardiovascular/renal complications in patients with COVID-19

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posted on 2022-03-11, 09:44 authored by Tom Norris, Cameron Razieh, Francesco Zaccardi, Thomas Yates, Nazrul Islam, Clare L Gillies, Yogini Chudasama, Alex Rowlands, Melanie J Davies, Gerry P McCann, Amitava Banerjee, Carolyn SP Lam, Annemarie B Docherty, Peter JM Openshaw, J Kenneth Baillie, Malcolm Gracie Semple, Claire Alexandra Lawson, Kamlesh Khunti


Using a large national database of people hospitalised with COVID-19, we investigated the contribution of cardio-metabolic conditions, multi-morbidity and ethnicity on the risk of in-hospital cardiovascular complications and death.


A multicentre, prospective cohort study in 302 UK healthcare facilities of adults hospitalised with COVID-19 between 6 February 2020 and 16 March 2021. Logistic models were used to explore associations between baseline patient ethnicity, cardiometabolic conditions and multimorbidity (0, 1, 2, >2 conditions), and in-hospital cardiovascular complications (heart failure, arrhythmia, cardiac ischaemia, cardiac arrest, coagulation complications, stroke), renal injury and death.


Of 65 624 patients hospitalised with COVID-19, 44 598 (68.0%) reported at least one cardiometabolic condition on admission. Cardiovascular/renal complications or death occurred in 24 609 (38.0%) patients. Baseline cardiometabolic conditions were independently associated with increased odds of in-hospital complications and this risk increased in the presence of cardiometabolic multimorbidity. For example, compared with having no cardiometabolic conditions, 1, 2 or ≥3 conditions was associated with 1.46 (95% CI 1.39 to 1.54), 2.04 (95% CI 1.93 to 2.15) and 3.10 (95% CI 2.92 to 3.29) times higher odds of any cardiovascular/renal complication, respectively. A similar pattern was observed for all-cause death. Compared with the white group, the South Asian (OR 1.19, 95% CI 1.10 to 1.29) and black (OR 1.53 to 95% CI 1.37 to 1.72) ethnic groups had higher risk of any cardiovascular/renal complication.


In hospitalised patients with COVID-19, cardiovascular complications or death impacts just under half of all patients, with the highest risk in those of South Asian or Black ethnicity and in patients with cardiometabolic multimorbidity.


This work was supported by the NIHR Leicester BRC, NIHR ARC-EM and a grant from the UKRI (MRC)-DHSC (NIHR) COVID-19 Rapid Response Rolling Call (MR/V020536/1), HDR-UK (HDRUK2020.138) the National Institute for Health Research (NIHR; award CO-CIN-01), the Medical Research Council (MRC; grant MC_PC_19059), and by the NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool. The funder/sponsor had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.



Norris T, Razieh C, Zaccardi F, et alImpact of cardiometabolic multimorbidity and ethnicity on cardiovascular/renal complications in patients with COVID-19Heart Published Online First: 15 December 2021. doi: 10.1136/heartjnl-2021-320047

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Diabetes Research Centre


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