Increased Risk of Acute Aortic Events following COVID-19 and Influenza Respiratory Viral Infections.

Autor:	Brooke BS; Division of Vascular Surgery, University of Utah Health, Salt Lake City, UT; Surgical Population Analysis Research Core (SPARC), Department of Surgery, University of Utah Health, Salt Lake City, UT. Electronic address: Benjamin.Brooke@hsc.utah.edu., Rosenfeld E; Division of Vascular Surgery, University of Utah Health, Salt Lake City, UT., Horns JJ; Surgical Population Analysis Research Core (SPARC), Department of Surgery, University of Utah Health, Salt Lake City, UT., Sarfati MR; Division of Vascular Surgery, University of Utah Health, Salt Lake City, UT., Kraiss LW; Division of Vascular Surgery, University of Utah Health, Salt Lake City, UT., Griffin CL; Division of Vascular Surgery, University of Utah Health, Salt Lake City, UT., Das R; Surgical Population Analysis Research Core (SPARC), Department of Surgery, University of Utah Health, Salt Lake City, UT., Longwolf KJ; Division of Vascular Surgery, University of Utah Health, Salt Lake City, UT., Johnson CE; Division of Vascular Surgery, University of Utah Health, Salt Lake City, UT.
Jazyk:	angličtina
Zdroj:	Annals of vascular surgery [Ann Vasc Surg] 2024 Dec; Vol. 109, pp. 225-231. Date of Electronic Publication: 2024 Jul 25.
DOI:	10.1016/j.avsg.2024.06.039
Abstrakt:	Background: Acute respiratory viral infections have been associated with an increased incidence of adverse cardiovascular events. However, it is unclear whether severe respiratory viral infections are associated with an increased risk of acute aortic syndromes (AAS). This study was designed to assess whether Coronavirus disease 2019 (COVID-19) and Influenza illnesses are associated with an increased incidence of subsequent AAS in the US population. Methods: We used the MarketScan database (2011-2021) to identify patients 18-99 years of age without prior diagnosis of aortic pathology who were diagnosed with COVID-19 or Influenza. Identified patients were matched 1:1 by age and sex to control patients without COVID-19 or Influenza. The primary outcome was incidence of AAS (dissection, intramural hematoma, penetrating aortic ulcer, or aneurysm rupture) within 180-days of a viral infection. The association between infection and risk of developing an AAS was analyzed using multivariate Cox proportional hazards models. Results: We identified 1,775,698 patients, including 779,229 (44%) with mild COVID-19, 42,141 (2%) with severe COVID-19, and 66,479 (4%) with Influenza that were matched to 887,849 (50%) control patients without COVID-19 or Influenza illnesses. A total of 164 patients experienced AAS within 6-months after diagnosis, which was highest among those after severe COVID-19. The predicted incidence of AAS was significantly higher among patients after severe COVID-19 (14.1 events/100,000 person-years), mild COVID-19 (13.3 events/100,000), and influenza (13.3 events/100,000) when compared to control patients (2.6 events/100,000). In risk-adjusted Cox regression models, severe COVID-19 (HR:5.4, 95% CI:2.8-10.4; P < 0.01), mild COVID-19 (HR:5.1, 95% CI:3.3-7.7; P < 0.01) and influenza (HR:5.1, 95% CI:2.6-9.7; P < 0.01) diagnoses were associated with a significantly increased risk of AAS within 180-days when compared to matched controls. Conclusions: There is an increased risk of developing acute aortic event in the months following illness with Influenza or COVID-19. These data highlight the need to closely monitor at-risk patients following a viral respiratory infection. (Published by Elsevier Inc.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu