COVID-19急性心血管并发症的全球洞察：CARDIO COVID- 19-20和WHF COVID-19 CVD研究的结果。

IF 3.2 2区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology Pub Date : 2025-06-01 DOI:10.1016/j.ijcard.2025.133458

Juan Esteban Gomez-Mesa , Juan Pablo Arango-Ibanez , David Alejandro Pantoja-Castro , Jose F. Fuertes-Bucheli , Paula Andrea Cárdenas-Marín , Hoover O. León-Giraldo , Andrea Valencia-Orozco , Pablo Perel , Dorairaj Prabhakaran , Kavita Singh , Ricardo Enrique Larrea Gómez , Cesar J. Herrera , Liliana Patricia Cárdenas Aldaz , Victor Rossel , Hugo Fernando Fernández , Ricardo Ramírez Ramírez , Clara Inés Saldarriaga , Ivan Criollo , Paula Silva , Karen Sliwa

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引用次数: 0

摘要

背景：COVID-19可导致急性和慢性心血管并发症。急性并发症包括心力衰竭、冠状动脉综合征、心律失常、心肌炎、肺栓塞等。这些并发症与先前存在的心血管疾病（CVD）有关，并增加不良后果的风险。我们对来自32个国家的COVID-19患者的急性心血管并发症进行了分析。方法：本队列研究结合了两项针对COVID-19住院成人的前瞻性多中心研究：CARDIO COVID- 19-20登记研究和WHF COVID-19 CVD研究。我们进行了描述性和多变量分析，以评估心血管并发症的发生率、相关因素及其与死亡率的相关性。结果：我们纳入了来自美洲、非洲、亚洲和欧洲的8045例患者。中位年龄59 岁（IQR 47-69）， 60.9% %为男性。发生心血管并发症1072例（13.3 %），最常见的是心律失常（448例，5.56 %）、急性心力衰竭（441例，5.48 %）和肺栓塞（227例，2.82 %）。心血管疾病患者的并发症发生率更高（33.1% %对10. %），ICU住院率更高（56. %对36.7 %），住院死亡率更高（40.4 %对13.2 %）。并发症发生率最高的是美洲（18.4 %）和欧洲（14.9 %）。危险因素包括年龄和心脏代谢合并症。回归分析显示，心血管并发症≥1例增加住院死亡风险（aRR 2.32, 95 % CI 2.10-2.55, p ）。结论：心血管并发症影响超过10 %的住院患者，且存在地区差异。这些事件与较高的死亡率相关，并且在心血管疾病患者中非常普遍。

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Global insights of acute cardiovascular complications of COVID-19: Findings from the CARDIO COVID 19–20 and WHF COVID-19 CVD studies

Background

COVID-19 can cause acute and chronic cardiovascular complications. Acute complications include heart failure, coronary syndrome, arrhythmias, myocarditis, pulmonary embolism, etc. These complications are linked to pre-existing cardiovascular disease (CVD) and increase the risk of adverse outcomes. We characterized acute cardiovascular complications in COVID-19 patients from 32 countries.

Methods

This cohort study combined two prospective, multicenter studies of hospitalized adults with COVID-19: the CARDIO COVID 19–20 registry and the WHF COVID-19 CVD study. We performed descriptive and multivariate analyses to assess the incidence of cardiovascular complications, associated factors, and their correlation with mortality.

Results

We included 8045 patients from the Americas, Africa, Asia, and Europe. Median age was 59 years (IQR 47–69), and 60.9 % were male. Cardiovascular complications occurred in 1072 patients (13.3 %), most commonly arrhythmias (448, 5.5 %), acute heart failure (441, 5.4 %), and pulmonary embolism (227, 2.8 %). Patients with CVD had higher complication rates (33.1 % vs. 10.2 %), more ICU admissions (56 % vs. 36.7 %), and higher in-hospital mortality (40.4 % vs. 13.2 %). The incidence of complications was highest in the Americas (18.4 %) and Europe (14.9 %). Risk factors included age and cardiometabolic comorbidities. Regression analysis showed that having ≥1 cardiovascular complication increased the risk of in-hospital mortality (aRR 2.32, 95 % CI 2.10–2.55, p < 0.001).

Conclusions

Cardiovascular complications affected over 10 % of hospitalized patients, with regional variations. These events were associated with higher mortality and were highly prevalent among those with CVD.

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来源期刊

International journal of cardiology 医学-心血管系统

CiteScore

6.80

自引率

5.70%

发文量

758

审稿时长

44 days

期刊介绍： The International Journal of Cardiology is devoted to cardiology in the broadest sense. Both basic research and clinical papers can be submitted. The journal serves the interest of both practicing clinicians and researchers. In addition to original papers, we are launching a range of new manuscript types, including Consensus and Position Papers, Systematic Reviews, Meta-analyses, and Short communications. Case reports are no longer acceptable. Controversial techniques, issues on health policy and social medicine are discussed and serve as useful tools for encouraging debate.