tetano
Editor, Senior Moderator
PLoS One
. 2022 Dec 30;17(12):e0279333.
doi: 10.1371/journal.pone.0279333. eCollection 2022.
One-year cardiovascular outcomes after coronavirus disease 2019: The cardiovascular COVID-19 registry
Luis Ortega-Paz[SUP] 1 2 [/SUP], Victor Arévalos[SUP] 1 [/SUP], Diego Fernández-Rodríguez[SUP] 3 [/SUP], Víctor Jiménez-Díaz[SUP] 4 [/SUP], Jordi Bañeras[SUP] 5 [/SUP], Gianluca Campo[SUP] 6 [/SUP], Miguel Rodríguez-Santamarta[SUP] 7 [/SUP], José Francisco Díaz[SUP] 8 [/SUP], Claudia Scardino[SUP] 9 [/SUP], Zaira Gómez-Álvarez[SUP] 10 [/SUP], Alberto Pernigotti[SUP] 11 [/SUP], Fernando Alfonso[SUP] 12 [/SUP], Ignacio J Amat-Santos[SUP] 13 [/SUP], Antonio Silvestro[SUP] 14 [/SUP], Lorenzo Rampa[SUP] 15 [/SUP], José M de la Torre Hernández[SUP] 16 [/SUP], Gabriela Bastidas[SUP] 17 [/SUP], Josep Gómez-Lara[SUP] 18 [/SUP], Behnood Bikdeli[SUP] 19 20 21 [/SUP], Hector M García-García[SUP] 22 [/SUP], Dominick J Angiolillo[SUP] 2 [/SUP], Josep Rodés-Cabau[SUP] 1 [/SUP], Manel Sabaté[SUP] 1 [/SUP], Salvatore Brugaletta[SUP] 1 [/SUP]; CV COVID-19 registry investigators
Affiliations
Abstract
Background: The long-term cardiovascular (CV) outcomes of COVID-19 have not been fully explored.
Methods: This was an international, multicenter, retrospective cohort study conducted between February and December 2020. Consecutive patients ≥18 years who underwent a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV2 were included. Patients were classified into two cohorts depending on the nasopharyngeal swab result and clinical status: confirmed COVID-19 (positive RT-PCR) and control (without suggestive symptoms and negative RT-PCR). Data were obtained from electronic records, and clinical follow-up was performed at 1-year. The primary outcome was CV death at 1-year. Secondary outcomes included arterial thrombotic events (ATE), venous thromboembolism (VTE), and serious cardiac arrhythmias. An independent clinical event committee adjudicated events. A Cox proportional hazards model adjusted for all baseline characteristics was used for comparing outcomes between groups. A prespecified landmark analysis was performed to assess events during the post-acute phase (31-365 days).
Results: A total of 4,427 patients were included: 3,578 (80.8%) in the COVID-19 and 849 (19.2%) control cohorts. At one year, there were no significant differences in the primary endpoint of CV death between the COVID-19 and control cohorts (1.4% vs. 0.8%; HRadj 1.28 [0.56-2.91]; p = 0.555), but there was a higher risk of all-cause death (17.8% vs. 4.0%; HRadj 2.82 [1.99-4.0]; p = 0.001). COVID-19 cohort had higher rates of ATE (2.5% vs. 0.8%, HRadj 2.26 [1.02-4.99]; p = 0.044), VTE (3.7% vs. 0.4%, HRadj 9.33 [2.93-29.70]; p = 0.001), and serious cardiac arrhythmias (2.5% vs. 0.6%, HRadj 3.37 [1.35-8.46]; p = 0.010). During the post-acute phase, there were no significant differences in CV death (0.6% vs. 0.7%; HRadj 0.67 [0.25-1.80]; p = 0.425), but there was a higher risk of deep vein thrombosis (0.6% vs. 0.0%; p = 0.028). Re-hospitalization rate was lower in the COVID-19 cohort compared to the control cohort (13.9% vs. 20.6%; p = 0.001).
Conclusions: At 1-year, patients with COVID-19 experienced an increased risk of all-cause death and adverse CV events, including ATE, VTE, and serious cardiac arrhythmias, but not CV death.
. 2022 Dec 30;17(12):e0279333.
doi: 10.1371/journal.pone.0279333. eCollection 2022.
One-year cardiovascular outcomes after coronavirus disease 2019: The cardiovascular COVID-19 registry
Luis Ortega-Paz[SUP] 1 2 [/SUP], Victor Arévalos[SUP] 1 [/SUP], Diego Fernández-Rodríguez[SUP] 3 [/SUP], Víctor Jiménez-Díaz[SUP] 4 [/SUP], Jordi Bañeras[SUP] 5 [/SUP], Gianluca Campo[SUP] 6 [/SUP], Miguel Rodríguez-Santamarta[SUP] 7 [/SUP], José Francisco Díaz[SUP] 8 [/SUP], Claudia Scardino[SUP] 9 [/SUP], Zaira Gómez-Álvarez[SUP] 10 [/SUP], Alberto Pernigotti[SUP] 11 [/SUP], Fernando Alfonso[SUP] 12 [/SUP], Ignacio J Amat-Santos[SUP] 13 [/SUP], Antonio Silvestro[SUP] 14 [/SUP], Lorenzo Rampa[SUP] 15 [/SUP], José M de la Torre Hernández[SUP] 16 [/SUP], Gabriela Bastidas[SUP] 17 [/SUP], Josep Gómez-Lara[SUP] 18 [/SUP], Behnood Bikdeli[SUP] 19 20 21 [/SUP], Hector M García-García[SUP] 22 [/SUP], Dominick J Angiolillo[SUP] 2 [/SUP], Josep Rodés-Cabau[SUP] 1 [/SUP], Manel Sabaté[SUP] 1 [/SUP], Salvatore Brugaletta[SUP] 1 [/SUP]; CV COVID-19 registry investigators
Affiliations
- PMID: 36583998
- DOI: 10.1371/journal.pone.0279333
Abstract
Background: The long-term cardiovascular (CV) outcomes of COVID-19 have not been fully explored.
Methods: This was an international, multicenter, retrospective cohort study conducted between February and December 2020. Consecutive patients ≥18 years who underwent a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV2 were included. Patients were classified into two cohorts depending on the nasopharyngeal swab result and clinical status: confirmed COVID-19 (positive RT-PCR) and control (without suggestive symptoms and negative RT-PCR). Data were obtained from electronic records, and clinical follow-up was performed at 1-year. The primary outcome was CV death at 1-year. Secondary outcomes included arterial thrombotic events (ATE), venous thromboembolism (VTE), and serious cardiac arrhythmias. An independent clinical event committee adjudicated events. A Cox proportional hazards model adjusted for all baseline characteristics was used for comparing outcomes between groups. A prespecified landmark analysis was performed to assess events during the post-acute phase (31-365 days).
Results: A total of 4,427 patients were included: 3,578 (80.8%) in the COVID-19 and 849 (19.2%) control cohorts. At one year, there were no significant differences in the primary endpoint of CV death between the COVID-19 and control cohorts (1.4% vs. 0.8%; HRadj 1.28 [0.56-2.91]; p = 0.555), but there was a higher risk of all-cause death (17.8% vs. 4.0%; HRadj 2.82 [1.99-4.0]; p = 0.001). COVID-19 cohort had higher rates of ATE (2.5% vs. 0.8%, HRadj 2.26 [1.02-4.99]; p = 0.044), VTE (3.7% vs. 0.4%, HRadj 9.33 [2.93-29.70]; p = 0.001), and serious cardiac arrhythmias (2.5% vs. 0.6%, HRadj 3.37 [1.35-8.46]; p = 0.010). During the post-acute phase, there were no significant differences in CV death (0.6% vs. 0.7%; HRadj 0.67 [0.25-1.80]; p = 0.425), but there was a higher risk of deep vein thrombosis (0.6% vs. 0.0%; p = 0.028). Re-hospitalization rate was lower in the COVID-19 cohort compared to the control cohort (13.9% vs. 20.6%; p = 0.001).
Conclusions: At 1-year, patients with COVID-19 experienced an increased risk of all-cause death and adverse CV events, including ATE, VTE, and serious cardiac arrhythmias, but not CV death.