Coronavirus Disease 2019 Severity and Risk of Subsequent Cardiovascular Events. (5th September 2022)

• Record Type: Journal Article
• Authors: Wiemken, Timothy L; McGrath, Leah J; Andersen, Kathleen M; Khan, Farid; Malhotra, Deepa; Alfred, Tamuno; Nguyen, Jennifer L; Puzniak, Laura; Thoburn, Elizabeth; Jodar, Luis; McLaughlin, John M
• Is Part Of: Clinical infectious diseases. Volume 76:Number 3(2023)
• Page Start: e42
• Page End: e50
• Publication Date: 2022-09-05
• Subjects: PASC -- postacute COVID-19 syndrome -- SARS-CoV-2 -- long COVID -- post-COVID syndrome; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciac661
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Little is known about the relationship between coronavirus disease 2019 (COVID-19) severity and subsequent risk of experiencing a cardiovascular event (CVE) after COVID-19 recovery. We evaluated this relationship in a large cohort of United States adults. Methods: Using a claims database, we performed a retrospective cohort study of adults diagnosed with COVID-19 between 1 April 2020 and 31 May 2021. We evaluated the association between COVID-19 severity and risk of CVE >30 days after COVID-19 diagnosis using inverse probability of treatment–weighted competing risks regression. Severity was based on level of care required for COVID-19 treatment: intensive care unit (ICU) admission, non-ICU hospitalization, or outpatient care only. Results: A total of 1 357 518 COVID-19 patients were included (2% ICU, 3% non-ICU hospitalization, and 95% outpatient only). Compared to outpatients, there was an increased risk of any CVE for patients requiring ICU admission (adjusted hazard ratio [aHR], 1.80 [95% confidence interval {CI}, 1.71–1.89]) or non-ICU hospitalization (aHR, 1.28 [95% CI, 1.24–1.33]). Risk of subsequent hospitalization for CVE was even higher (aHRs, 3.47 [95% CI, 3.20–3.76] for ICU and 1.96 [95% CI, 1.85–2.09] for non-ICU hospitalized vs outpatient only). Conclusions: COVID-19 patients hospitalized or requiring critical care had a significantly higher risk of experiencing and being hospitalized for post–COVID-19 CVE than patients with milder COVID-19 who were managed solely in the outpatient setting, even after adjusting for differences between these groups. These findings underscore the continued importance of preventing severe acute respiratory syndrome coronavirus 2 infection from progressing to severe illness to reduce potential long-term cardiovascular complications. Abstract : COVID-19 patients hospitalized with or without intensive care unit admission had 80% and 28%, respectively, higher risk of post–COVID-19 cardiovascular events and were 2–4 times more likely to be hospitalized for a subsequent cardiovascular event than those requiring outpatient care only.