{"title":"16个国家COVID-19住院患者的长冠状病毒综合征、死亡率和发病率:世界心脏联合会全球COVID-19研究","authors":"Karen Sliwa, Kavita Singh, Kalyani Nikhare, Dimple Kondal, Lana Raspail, Meetushi Jain, Shahin Akter, Shamim Hayder Talukder, Toru Kato, Silvia Bertagnolio, Jamie Rylance, Amitava Banerjee, Jagat Narula, Daniel Pineiro, Pablo Perel, Dorairaj Prabhakaran","doi":"10.5334/gh.1452","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Long-term adverse consequences of the COVID-19 infection affect many organ systems, which requires comprehensive understanding of the disease burden and determinants of persistent long COVID-19 symptoms in diverse population. However, data on long COVID complications are sparse, particularly from low- and middle-income countries (LMICs). The World Heart Federation (WHF) global study assessed the incidence of vascular complications, persistent long COVID symptoms and factors associated with mortality and major adverse cardiovascular events (MACE) among patients with COVID-19 up to one year after hospitalization.</p><p><strong>Methods: </strong>We recruited a total of 2535 patients hospitalized with COVID-19 and followed up to one-year post-hospital discharge. We collected data on long COVID symptoms, quality of life, and clinical outcomes, including new onset diseases, MACE, and mortality at 1-, 3-, 6-, and 9-12 months post-discharge. Descriptive and generalized estimating equation (GEE) regression analysis was performed to assess the factors associated with mortality and MACE.</p><p><strong>Findings: </strong>The majority of participants were recruited from LMICs (64%) and male (56%) with a mean (SD) age of 59.5 (20.0) years. Among those tested for COVID-19 strain (52%), Omicron strain was the most prevalent (98%). The follow-up rate at one year was 90%. Over half of the participants (56%) reported experiencing at least one major long COVID symptom (fatigue, breathlessness, anxiety, chest pain, and palpitations) at 1-month, and one-quarter participants reported persistent long COVID symptoms at 9-12 months. On the EQ-5D scale, 49% reported difficulties in usual activities, 33% reported anxiety/depression, and 23% reported problems in mobility within the first 6 months. The most frequent new-onset illnesses were pulmonary embolism (8%), kidney disease (4%), and hypertension (3%). The cumulative all-cause mortality rate was 15% (n = 382) at one-year post-discharge. Long COVID symptoms were more common among females, individuals with pre-existing comorbidities, and those with more severe acute illness. Age, obesity, ICU admission, and underlying cardiovascular or pulmonary disease were associated with increased risk of mortality and MACE.</p><p><strong>Conclusion: </strong>The study showed a substantial burden of mortality and morbidity, and a quarter of patients reported at least one persistent long COVID symptom after one year. Our findings underscore the need for early identification and management of long COVID symptoms in LMICs.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"66"},"PeriodicalIF":3.1000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315686/pdf/","citationCount":"0","resultStr":"{\"title\":\"Long COVID Syndrome, Mortality and Morbidity in Patients Hospitalized with COVID-19 From 16 Countries: The World Heart Federation Global COVID-19 Study.\",\"authors\":\"Karen Sliwa, Kavita Singh, Kalyani Nikhare, Dimple Kondal, Lana Raspail, Meetushi Jain, Shahin Akter, Shamim Hayder Talukder, Toru Kato, Silvia Bertagnolio, Jamie Rylance, Amitava Banerjee, Jagat Narula, Daniel Pineiro, Pablo Perel, Dorairaj Prabhakaran\",\"doi\":\"10.5334/gh.1452\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Long-term adverse consequences of the COVID-19 infection affect many organ systems, which requires comprehensive understanding of the disease burden and determinants of persistent long COVID-19 symptoms in diverse population. However, data on long COVID complications are sparse, particularly from low- and middle-income countries (LMICs). The World Heart Federation (WHF) global study assessed the incidence of vascular complications, persistent long COVID symptoms and factors associated with mortality and major adverse cardiovascular events (MACE) among patients with COVID-19 up to one year after hospitalization.</p><p><strong>Methods: </strong>We recruited a total of 2535 patients hospitalized with COVID-19 and followed up to one-year post-hospital discharge. We collected data on long COVID symptoms, quality of life, and clinical outcomes, including new onset diseases, MACE, and mortality at 1-, 3-, 6-, and 9-12 months post-discharge. Descriptive and generalized estimating equation (GEE) regression analysis was performed to assess the factors associated with mortality and MACE.</p><p><strong>Findings: </strong>The majority of participants were recruited from LMICs (64%) and male (56%) with a mean (SD) age of 59.5 (20.0) years. Among those tested for COVID-19 strain (52%), Omicron strain was the most prevalent (98%). The follow-up rate at one year was 90%. Over half of the participants (56%) reported experiencing at least one major long COVID symptom (fatigue, breathlessness, anxiety, chest pain, and palpitations) at 1-month, and one-quarter participants reported persistent long COVID symptoms at 9-12 months. On the EQ-5D scale, 49% reported difficulties in usual activities, 33% reported anxiety/depression, and 23% reported problems in mobility within the first 6 months. The most frequent new-onset illnesses were pulmonary embolism (8%), kidney disease (4%), and hypertension (3%). The cumulative all-cause mortality rate was 15% (n = 382) at one-year post-discharge. Long COVID symptoms were more common among females, individuals with pre-existing comorbidities, and those with more severe acute illness. Age, obesity, ICU admission, and underlying cardiovascular or pulmonary disease were associated with increased risk of mortality and MACE.</p><p><strong>Conclusion: </strong>The study showed a substantial burden of mortality and morbidity, and a quarter of patients reported at least one persistent long COVID symptom after one year. Our findings underscore the need for early identification and management of long COVID symptoms in LMICs.</p>\",\"PeriodicalId\":56018,\"journal\":{\"name\":\"Global Heart\",\"volume\":\"20 1\",\"pages\":\"66\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315686/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Global Heart\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5334/gh.1452\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Global Heart","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5334/gh.1452","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Long COVID Syndrome, Mortality and Morbidity in Patients Hospitalized with COVID-19 From 16 Countries: The World Heart Federation Global COVID-19 Study.
Background: Long-term adverse consequences of the COVID-19 infection affect many organ systems, which requires comprehensive understanding of the disease burden and determinants of persistent long COVID-19 symptoms in diverse population. However, data on long COVID complications are sparse, particularly from low- and middle-income countries (LMICs). The World Heart Federation (WHF) global study assessed the incidence of vascular complications, persistent long COVID symptoms and factors associated with mortality and major adverse cardiovascular events (MACE) among patients with COVID-19 up to one year after hospitalization.
Methods: We recruited a total of 2535 patients hospitalized with COVID-19 and followed up to one-year post-hospital discharge. We collected data on long COVID symptoms, quality of life, and clinical outcomes, including new onset diseases, MACE, and mortality at 1-, 3-, 6-, and 9-12 months post-discharge. Descriptive and generalized estimating equation (GEE) regression analysis was performed to assess the factors associated with mortality and MACE.
Findings: The majority of participants were recruited from LMICs (64%) and male (56%) with a mean (SD) age of 59.5 (20.0) years. Among those tested for COVID-19 strain (52%), Omicron strain was the most prevalent (98%). The follow-up rate at one year was 90%. Over half of the participants (56%) reported experiencing at least one major long COVID symptom (fatigue, breathlessness, anxiety, chest pain, and palpitations) at 1-month, and one-quarter participants reported persistent long COVID symptoms at 9-12 months. On the EQ-5D scale, 49% reported difficulties in usual activities, 33% reported anxiety/depression, and 23% reported problems in mobility within the first 6 months. The most frequent new-onset illnesses were pulmonary embolism (8%), kidney disease (4%), and hypertension (3%). The cumulative all-cause mortality rate was 15% (n = 382) at one-year post-discharge. Long COVID symptoms were more common among females, individuals with pre-existing comorbidities, and those with more severe acute illness. Age, obesity, ICU admission, and underlying cardiovascular or pulmonary disease were associated with increased risk of mortality and MACE.
Conclusion: The study showed a substantial burden of mortality and morbidity, and a quarter of patients reported at least one persistent long COVID symptom after one year. Our findings underscore the need for early identification and management of long COVID symptoms in LMICs.
Global HeartMedicine-Cardiology and Cardiovascular Medicine
CiteScore
5.70
自引率
5.40%
发文量
77
审稿时长
5 weeks
期刊介绍:
Global Heart offers a forum for dialogue and education on research, developments, trends, solutions and public health programs related to the prevention and control of cardiovascular diseases (CVDs) worldwide, with a special focus on low- and middle-income countries (LMICs). Manuscripts should address not only the extent or epidemiology of the problem, but also describe interventions to effectively control and prevent CVDs and the underlying factors. The emphasis should be on approaches applicable in settings with limited resources.
Economic evaluations of successful interventions are particularly welcome. We will also consider negative findings if important. While reports of hospital or clinic-based treatments are not excluded, particularly if they have broad implications for cost-effective disease control or prevention, we give priority to papers addressing community-based activities. We encourage submissions on cardiovascular surveillance and health policies, professional education, ethical issues and technological innovations related to prevention.
Global Heart is particularly interested in publishing data from updated national or regional demographic health surveys, World Health Organization or Global Burden of Disease data, large clinical disease databases or registries. Systematic reviews or meta-analyses on globally relevant topics are welcome. We will also consider clinical research that has special relevance to LMICs, e.g. using validated instruments to assess health-related quality-of-life in patients from LMICs, innovative diagnostic-therapeutic applications, real-world effectiveness clinical trials, research methods (innovative methodologic papers, with emphasis on low-cost research methods or novel application of methods in low resource settings), and papers pertaining to cardiovascular health promotion and policy (quantitative evaluation of health programs.