Cardiovascular complications in the course of COVID-19 - lessons learned and implications for the future care of patients with viral respiratory diseases: Data from a single center retrospective observational study.

Autor: Krogulec D; Department of Adults' Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland., Bieńkowski C; Department of Adults' Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland. Electronic address: carlo.bienkowski@gmail.com., Kowalska JD; Department of Adults' Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland., Bednarska A; Department of Adults' Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland., Wojtycha-Kwaśnica B; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland., Jurek N; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland., Ząbek P; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland., Czeszko-Paprocka H; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland., Mrozińska M; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland., Paciorek M; Department of Adults' Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland., Pihowicz A; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland., Horban A; Department of Adults' Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, 01-201 Warsaw, Poland.
Jazyk: angličtina
Zdroj: Heart & lung : the journal of critical care [Heart Lung] 2024 Nov-Dec; Vol. 68, pp. 116-125. Date of Electronic Publication: 2024 Jun 29.
DOI: 10.1016/j.hrtlng.2024.06.009
Abstrakt: Background: Factors associated with cardiovascular complications of COVID-19 remain understudied.
Objectives: Here we investigate the occurrence and risk factors of arrythmias, myocardial infarction and/or stroke, and thromboembolism in the course of COVID-19.
Methods: We have performed an observational study with prospectively designed data collection. Data of patients diagnosed with COVID-19 who were admitted from March 6th 2020 to November 30th 2021 in our Hospital were analyzed. Logistic regression was used to identify variables associated with the odds of early hospital death due to COVID-19.
Results: Fourteen-point three percent of 1964 patients had cardiovascular complications, 6.36 % arrhythmias, 5.5 % thromboembolic events and 2.39 % myocardial infarction and/or stroke. Factors independently increasing the odds of arrhythmia were older age (OR=1.49 [95 % CI: 1.17-1.92], p = 0.02), longer time between admission and the first onset of symptoms (1.02 [0.99-1.05], p = 0.049), concomitant atrial fibrillation/flutter (2.84 [1.37-5.70], p = 0.004), nicotinism (2.49 [1.37-4.49], p = 0.002), and eGFR<60 ml/min/1.73m 2 (2.44 [1.08-5.59], p = 0.033). Factors independently increasing the odds of myocardial infarction and/or stroke were dementia (4.55 [0.97-19.3], p = 0.044), hemiplegia (12.67 [3.12-46.1], p < 0.001), nicotinism (3.36 [1.30-10.4], p = 0.013) and higher C-reactive protein concentration (1.01 [1.00-1.01], p = 0.040). Factors independently increasing the odds of thromboembolic events were longer hospitalization (1.08 [1.05-1.10], p < 0.001) and higher d-dimers (1.04 [1.02-1.05], <0.001).
Conclusions: The risk of cardiovascular complications was especially pronounced in patients with older age, pre-existing cardiovascular disease and more sever pneumonia at presentation to care. This underlines the importance of close and careful clinical follow-up in the course of COVID-19 for specific patients' populations, including a pro-active approach in diagnosis.
Competing Interests: Declaration of competing interest None.
(Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: