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J Clin Med . Post-COVID-19 Symptoms and Heart Disease: Incidence, Prognostic Factors, Outcomes and Vaccination: Results from a Multi-Center Internat

tetano

Editor, Senior Moderator
J Clin Med


. 2023 Jan 16;12(2):706.
doi: 10.3390/jcm12020706.
Post-COVID-19 Symptoms and Heart Disease: Incidence, Prognostic Factors, Outcomes and Vaccination: Results from a Multi-Center International Prospective Registry (HOPE 2)


Ivan J Núñez-Gil[SUP] 1 2 [/SUP], Gisela Feltes[SUP] 2 3 [/SUP], María C Viana-Llamas[SUP] 4 [/SUP], Sergio Raposeiras-Roubin[SUP] 5 [/SUP], Rodolfo Romero[SUP] 6 [/SUP], Emilio Alfonso-Rodríguez[SUP] 7 [/SUP], Aitor Uribarri[SUP] 8 [/SUP], Francesco Santoro[SUP] 9 [/SUP], Víctor Becerra-Muñoz[SUP] 10 [/SUP], Martino Pepe[SUP] 11 [/SUP], Alex F Castro-Mejía[SUP] 12 [/SUP], Jaime Signes-Costa[SUP] 13 [/SUP], Adelina Gonzalez[SUP] 14 [/SUP], Francisco Marín[SUP] 15 [/SUP], Javier Lopez-País[SUP] 16 [/SUP], Enrico Cerrato[SUP] 17 [/SUP], Olalla Vázquez-Cancela[SUP] 18 [/SUP], Carolina Espejo-Paeres[SUP] 19 [/SUP], Álvaro López Masjuan[SUP] 20 [/SUP], Lazar Velicki[SUP] 21 22 [/SUP], Ibrahim El-Battrawy[SUP] 23 24 [/SUP], Harish Ramakrishna[SUP] 25 [/SUP], Antonio Fernandez-Ortiz[SUP] 1 [/SUP], Julián Perez-Villacastín[SUP] 1 [/SUP]; HOPE-2 Investigators



Affiliations
Free article

Abstract

Background: Heart disease is linked to worse acute outcomes after coronavirus disease 2019 (COVID-19), although long-term outcomes and prognostic factor data are lacking. We aim to characterize the outcomes and the impact of underlying heart diseases after surviving COVID-19 hospitalization.
Methods: We conducted an analysis of the prospective registry HOPE-2 (Health Outcome Predictive Evaluation for COVID-19-2, NCT04778020). We selected patients discharged alive and considered the primary end-point all-cause mortality during follow-up. As secondary main end-points, we included any readmission or any post-COVID-19 symptom. Clinical features and follow-up events are compared between those with and without cardiovascular disease. Factors with p < 0.05 in the univariate analysis were entered into the multivariate analysis to determine independent prognostic factors.
Results: HOPE-2 closed on 31 December 2021, with 9299 patients hospitalized with COVID-19, and 1805 died during this acute phase. Finally, 7014 patients with heart disease data were included in the present analysis, from 56 centers in 8 countries. Heart disease (+) patients were older (73 vs. 58 years old), more frequently male (63 vs. 56%), had more comorbidities than their counterparts, and suffered more frequently from post-COVID-19 complications and higher mortality (OR [SUB]heart disease[/SUB]: 2.63, 95% CI: 1.81-3.84). Vaccination was found to be an independent protector factor (HR [SUB]all-cause death[/SUB]: 0.09; 95% CI: 0.04-0.19).
Conclusions: After surviving the acute phase, patients with underlying heart disease continue to present a more complex clinical profile and worse outcomes including increased mortality. The COVID-19 vaccine could benefit survival in patients with heart disease during follow-up.

Keywords: COVID-19; cardiology; heart disease; mortality; persistent; prognosis.
 
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