When COVID-19 began to spread across the U.S. a year ago, a group of cardiologists at UT Southwestern brainstormed how they could contribute to what they called “the medical fight of our lives.” They came up with the idea of creating a national COVID-19 registry of cardiac patients and approached the American Heart Association (AHA) to develop the nationwide network.
Today, thanks to their initiative and hard work, the AHA’s COVID-19 Cardiovascular Disease Registry has gathered records on more than 30,000 patients from 34 states, including data points on patient demographics, cardiovascular risk factors, comorbidities, medications prior to admission, treatments during hospitalization, disease severity measures, and laboratory results.
As a result, UTSW cardiologists are leading national efforts to understand and reduce the effects of COVID-19 on cardiac patients. As of February, more than 40 investigations were in progress across the country using the registry.
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Much of the drive behind the project came from UTSW’s cardiology fellows, said Dr. James de Lemos, Professor of Internal Medicine who served as co-Chair of the steering committee for the registry together with Dr. Sandeep Das, Associate Professor of Internal Medicine at UTSW.
“UT Southwestern has always attracted energetic, creative young people as cardiology fellows. This group established the foundation for this registry through their work early in the pandemic studying the impact of COVID-19 on our own cardiac patients at William P. Clements Jr. University Hospital and Parkland Memorial Hospital. The fellows have stayed involved with the registry and now are major drivers of the scientific results,” de Lemos said.
Setting up a registry, collecting and analyzing data, and then publishing results would normally take two years. These cardiologists did the same in just six months, in part by setting in motion parallel pathways to conduct research by multiple groups simultaneously. One early but encouraging finding: Rates of serious heart complications in COVID-19 patients were lower than feared at first.
“The good news is that fewer than 5 percent of cardiac patients will have major heart complications from COVID-19. The problem is that with the quantity of COVID-19 cases we’re seeing, even 5 percent is a great deal of heart cases,” said Dr. de Lemos, who noted that the most common complications are injury to the heart, followed by blood clots that can cause heart attacks, strokes, and pulmonary embolism.
The first paper based on data from the effort was published just seven months after the registry was launched in April. The research, presented at the annual AHA Scientific Sessions in November, showed that Black and Hispanic people were more likely to be hospitalized with COVID-19 than white patients, and were more likely to die. Currently, more than 58 percent of patients in the COVID-19 cardiac registry are Black or Hispanic, and these two groups account for 50 percent of virus fatalities overall in the registry.
According to Dr. de Lemos, long-standing social factors that precede the pandemic, rather than differences in hospital care, contributed to these inequities. Factors such as more crowded living spaces, employment in essential jobs that did not allow working from home, greater use of public transportation, lack of health insurance, and restricted access to medical care all may have played an important role in the terrible burden of the pandemic for Black and Hispanic Americans.
As the U.S. recognizes February as American Heart Month, Dr. de Lemos emphasized that no one should delay emergency or hospital care for a suspected stroke or heart attack due to fears of contracting COVID-19. “People need to know it’s safe to seek care at their hospital because we follow every safety precaution,” he said.
While progress has been made in the pandemic through better treatments and distributing vaccines, Dr. de Lemos also sees challenges ahead.
“We’re at the beginning of the end, but the fight is far from over. We’ve got to get our feet under us regarding these new virus variants and improve our knowledge of their impact on the pandemic. This registry will help us to achieve that understanding.”