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Background/Aims: COVID-19 has led to substantial changes in the provision of emergency healthcare services. International data suggest that COVID-19 is associated with increased morbidity and mortality in patients with pre-existing cardiovascular disease and cardiovascular risk factors. This study aimed to explore the association between pre-existing cardiovascular disease and/or cardiovascular risk factors and COVID-19 disease severity and outcomes in an Irish hospital. Methods: This retrospective study obtained data from a bioresource database of patients with confirmed COVID-19 infection (n=649) in a large hospital in Dublin. Data were collected on patients' demographic characteristics, cardiovascular diseases, cardiovascular disease risk factors and medications taken for cardiovascular conditions. The World Health Organization progression scale was used to assess the severity of COVID-19 infection in each patient. Cross-tabulation analysis was used to analyse associations between variables, with a P value of ≤0.05 indicating significance. Results: Mortality rates were six times greater in patients with cardiovascular disease compared to those without cardiovascular disease (18.6% vs 3.1%). A higher percentage of patients with one or more cardiovascular risk factors had moderate (53.4%) or severe (19.1%) COVID-19 and higher mortality rates (10.7%) than those without cardiovascular risk factors. Of the patients who died from COVID-19 (n=40), 60.0% (n=24) had one or more cardiovascular diseases, while 80.0% (n=32) had one or more cardiovascular risk factors. Conclusions: Existing cardiovascular disease and cardiovascular risk factors increase the risk of more severe disease and worse clinical outcomes in patients with COVID-19. Many cardiovascular risk factors are modifiable, so it is important to consider preventative education strategies designed to reduce modifiable risk factors to improve outcomes for patients with COVID-19. [ABSTRACT FROM AUTHOR]

Objectives: Women who inherit a pathogenic BRCA1 or BRCA2 mutation are at substantially higher risk of developing breast and ovarian cancer than average. Several cancer risk management strategies exist to address this increased risk. Decisions about which strategies to choose are complex, personal and multifactorial for these women. Decision aids (DAs) are tools that assist patients in making health-related decisions. The aim of this scoping review was to map evidence relating to the development and testing of patient DAs for cancer unaffected BRCA mutation carriers., Design: Scoping review conducted according to the Joanna Briggs Institute's (JBI's) scoping review methodological framework., Data Sources: MEDLINE, EMBASE, CINAHL, Web of Science. No restrictions applied for language or publication date. A manual search was also performed., Eligibility Criteria for Selecting Studies: Studies on DAs for cancer risk management designed for or applicable to women with a pathogenic BRCA1 or BRCA2 mutation who are unaffected by breast or ovarian cancer., Data Extraction and Synthesis: Data were extracted using a form based on the JBI instrument for extracting details of studies' characteristics and results. Data extraction was performed independently by two reviewers. Extracted data were tabulated., Results: 32 evidence sources relating to development or testing of 21 DAs were included. Four DAs were developed exclusively for cancer unaffected BRCA mutation carriers. Of these, two covered all guideline recommended risk management strategies for this population though only one of these was readily available publicly in its full version. All studies investigating DA effectiveness reported a positive effect of the DA under investigation on at least one of the outcomes evaluated, however only six DAs were tested in randomised controlled trials., Conclusion: This scoping review has mapped the landscape of the literature relating to developing and testing, DAs applicable to cancer unaffected BRCA mutation carriers., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)