Prognostic Impact of Acute Cardiovascular Events in COVID-19 Hospitalized Patients—Results from the CORONA Germany Study
| Autor: | Christoph U. Herborn, Ruediger Schreiber, Philipp Anders, Martin Bergmann, Nele Gessler, Berthold Bein, Melanie Gunawardene, Kai Jaquet, Dirk Arnold, Klaus Herrlinger, Axel Stang, Stephan Willems, Kathrin Heitmann, Claas Wesseler, Peter Wohlmuth |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Acute coronary syndrome Myocarditis business.industry troponin coronavirus COVID-19 Atrial fibrillation General Medicine Odds ratio medicine.disease Article cardiovascular disease Internal medicine Epidemiology medicine Clinical endpoint Medicine atrial fibrillation business Stroke Cohort study |
| Zdroj: | Journal of Clinical Medicine Volume 10 Issue 17 Journal of Clinical Medicine, Vol 10, Iss 3982, p 3982 (2021) |
| ISSN: | 2077-0383 |
| Popis: | Background: Acute myocardial injury (AMJ), assessed by elevated levels of cardiac troponin, is associated with fatal outcome in coronavirus disease 2019 (COVID-19). However, the role of acute cardiovascular (CV) events defined by clinical manifestation rather than sole elevations of biomarkers is unclear in hospitalized COVID-19 patients. Objective: The aim of this study was to investigate acute clinically manifest CV events in hospitalized COVID-19 patients. Methods: From 1 March 2020 to 5 January 2021, we conducted a multicenter, prospective, epidemiological cohort study at six hospitals from Hamburg, Germany (a portion of the state-wide 45-center CORONA Germany cohort study) enrolling all hospitalized COVID-19 patients. Primary endpoint was occurrence of a clinically manifest CV-event. Results: In total, 132 CV-events occurred in 92 of 414 (22.2%) patients in the Hamburg-cohort: cardiogenic shock in 10 (2.4%), cardiopulmonary resuscitation in 12 (2.9%), acute coronary syndrome in 11 (2.7%), de-novo arrhythmia in 31 (7.5%), acute heart-failure in 43 (10.3%), myocarditis in 2 (0.5%), pulmonary-embolism in 11 (2.7%), thrombosis in 9 (2.2%) and stroke in 3 (0.7%). In the Hamburg-cohort, mortality was 46% (42/92) for patients with a CV-event and 33% (27/83) for patients with only AMJ without CV-event (OR 1.7, CI: (0.94–3.2), p = 0.077). Mortality was higher in patients with CV-events (Odds ratio(OR): 4.8, 95%-confidence-interval(CI): [2.9–8]). Age (OR 1.1, CI: (0.66–1.86)), atrial fibrillation (AF) on baseline-ECG (OR 3.4, CI: (1.74–6.8)), systolic blood-pressure (OR 0.7, CI: (0.53–0.96)), potassium (OR 1.3, CI: (0.99–1.73)) and C-reactive-protein (1.4, CI (1.04–1.76)) were associated with CV-events. Conclusion: Hospitalized COVID-19 patients with clinical manifestation of acute cardiovascular events show an almost five-fold increased mortality. In this regard, the emergence of arrhythmias is a major determinant. |
| Databáze: | OpenAIRE |
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