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Background <p>Post-COVID condition encompasses a spectrum of persistent or emerging symptoms affecting multiple organ systems, including a heightened risk of cardiovascular complications. Despite growing recognition of this phenomenon, there remains a lack of comprehensive data regarding the incidence and risk factors associated with cardiovascular events during the post-acute phase in patients previously hospitalised for COVID-19. Thus, we aimed to estimate the incidence of cardiovascular events among patients hospitalised for COVID-19 in Portugal and assess the association between patient and infection characteristics and cardiovascular events in the COVID-19 post-acute phase.</p> Methods <p>We conducted a registry-based retrospective cohort study from seven hospitals across Portugal. Data was retrospectively collected from the electronic medical record of each patient. We included individuals hospitalised due to COVID-19 between March 2020 and March 2021. Our outcome of interest was cardiovascular events in the post-acute phase of COVID-19, occurring at least 30&#xa0;days after a positive SARS-CoV-2 test. The variables of interest considered were the severity of the episode, existing cardiovascular risk and vaccination status before the SARS-CoV-2 test. Person-years was estimated for each individual, and incidence rates were estimated. A Cox proportional hazard regression model was employed to assess risk factors.</p> Results <p>We included 1,803 patients in the analysis, of which 143 (7.9%) experienced at least one cardiovascular event following COVID-19 hospitalisation. The overall incidence rate of having at least one cardiovascular event was 34.65 per 1,000 person-years (95% confidence interval (CI): 29.20; 40.82). We found higher risk of cardiovascular events for individuals with pre-existing cardiovascular risk (adjusted hazard ratio (aHR): 3.76, 95% CI: 1.53; 9.24) and lower risk for individuals with at least one vaccine dose before the SARS-CoV-2 test (partial vaccination – aHR: 0.44, 95%CI: 0.30; 0.64, complete vaccination – aHR: 0.46, 95%CI: 0.2; 0.80). We did not find a significant difference between the severity of the COVID-19 episode and the risk of having cardiovascular events post-COVID-19.</p> Conclusion <p>Our findings suggest a substantial burden of cardiovascular complications post-COVID-19, underscoring the need for health services to be prepared and commence screening and preventive measures for individuals at higher risk.</p>

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Long-term cardiovascular events in individuals hospitalised with COVID-19: a retrospective cohort

  • 期刊论文

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  • 发表日期：

    2025年11月7日

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  • Patrícia Soares,
  • Carolina Ruivinho,
  • Joana Silva,
  • Maria João Lobão,
  • Lelita Santos,
  • Joana Paixão,
  • Ana Rita Ramalho,
  • Adriana Henriques,
  • Inês Simões,
  • Luísa Eça Guimarães,
  • Rita Moça,
  • Andreia Costa,
  • Gabriel Atanásio,
  • Sofia Nóbrega,
  • Maria da Luz Brazão,
  • Ana Rita Goes,
  • Andreia Leite,
  • Marta Moniz,
  • Andreia Vilas-Boas,
  • Víctor Ramos,
  • João V. Cordeiro,
  • Patrícia Barbosa,
  • André Peralta Santos,
  • António Carlos da Silva,
  • Mário Santos,
  • Marta Sofia Fonseca,
  • João Victor Rocha,
  • Sónia Dias,
  • Rita Tinoco Magalhães,
  • Beatriz Fernandes,
  • Rita Relvas,
  • Soraia Mendes,
  • Joana Gomes da Cunha,
  • Daniela Costa Duarte,
  • Andreia Ferreira Moreira Lopes,
  • Catarina Rodrigues da Silva,
  • Carolina Anjo,
  • Dora C. Gomes,
  • Filipa Rodrigues dos Reis,
  • Henrique Elvas,
  • Hugo Ventura,
  • Ines Guimarães Rento,
  • Alexandra Malheiro,
  • Carolina Aguiar,
  • Carolina Barros,
  • Carolina Morna,
  • Miriam Capelo,
  • Catarina Nóbrega,
  • Diogo André,
  • Filipe Perneta,
  • Helena Luís,
  • João Gaspar,
  • Mariana Bilrreiro,
  • Mariana Gomes,
  • Paula Caldeira,
  • Ana Isabel Costa,
  • Pedro Balza,
  • Rubina Miranda,
  • Sofia Gonçalves,
  • Sofia Almada,
  • Brenda Soares,
  • Francisco Barreto,
  • Madalena Pestana,
  • Rui Fernandes,
  • Sara Gomes,
  • Carolina Henriques,
  • Ana Isabel Lopes,
  • Filipa de Azevedo,
  • Gert Jan Van Der Heijden,
  • Inês Burmester,
  • Eduarda Martins,
  • Raquel Cruz,
  • Gonçalo Mesquita,
  • Ana Catarina Trigo,
  • Ana Sofia Silva,
  • Sónia Fernandes,
  • Andreia Mandim,
  • Rubina Silva,
  • Fani Ribeiro,
  • Raquel Santos,
  • Raquel Oliveira,
  • Carla Maia,
  • Christine Canizes,
  • Cristiane Macedo,
  • Helena Rodrigues,
  • José Artur Magalhães,
  • Ana Filipa Fernandes,
  • Diogo Alves Leal,
  • Mariana Portugal,
  • Maria João Rocha,
  • João Peixoto,
  • Ricardo Velho,
  • Manuel Maia,
  • Tiago Jorge Costa,
  • Carolina Martins,
  • Odete Duarte,
  • Daniela Maurício

摘要

Background

Post-COVID condition encompasses a spectrum of persistent or emerging symptoms affecting multiple organ systems, including a heightened risk of cardiovascular complications. Despite growing recognition of this phenomenon, there remains a lack of comprehensive data regarding the incidence and risk factors associated with cardiovascular events during the post-acute phase in patients previously hospitalised for COVID-19. Thus, we aimed to estimate the incidence of cardiovascular events among patients hospitalised for COVID-19 in Portugal and assess the association between patient and infection characteristics and cardiovascular events in the COVID-19 post-acute phase.

Methods

We conducted a registry-based retrospective cohort study from seven hospitals across Portugal. Data was retrospectively collected from the electronic medical record of each patient. We included individuals hospitalised due to COVID-19 between March 2020 and March 2021. Our outcome of interest was cardiovascular events in the post-acute phase of COVID-19, occurring at least 30 days after a positive SARS-CoV-2 test. The variables of interest considered were the severity of the episode, existing cardiovascular risk and vaccination status before the SARS-CoV-2 test. Person-years was estimated for each individual, and incidence rates were estimated. A Cox proportional hazard regression model was employed to assess risk factors.

Results

We included 1,803 patients in the analysis, of which 143 (7.9%) experienced at least one cardiovascular event following COVID-19 hospitalisation. The overall incidence rate of having at least one cardiovascular event was 34.65 per 1,000 person-years (95% confidence interval (CI): 29.20; 40.82). We found higher risk of cardiovascular events for individuals with pre-existing cardiovascular risk (adjusted hazard ratio (aHR): 3.76, 95% CI: 1.53; 9.24) and lower risk for individuals with at least one vaccine dose before the SARS-CoV-2 test (partial vaccination – aHR: 0.44, 95%CI: 0.30; 0.64, complete vaccination – aHR: 0.46, 95%CI: 0.2; 0.80). We did not find a significant difference between the severity of the COVID-19 episode and the risk of having cardiovascular events post-COVID-19.

Conclusion

Our findings suggest a substantial burden of cardiovascular complications post-COVID-19, underscoring the need for health services to be prepared and commence screening and preventive measures for individuals at higher risk.