Cuomo Gianluca, Puzzolante Cinzia, Iadisernia Vittorio, Santoro Antonella, Menozzi Marianna, Carli Federica, Digaetano Margherita, Orlando Gabriella, Franceschini Erica, Bedini Andrea, Meschiari Marianna, Manzini Lisa, Corradi Luca, Milic Jovana, Borghi Vanni, Brugioni Lucio, Pietrangelo Antonello, Clini Enrico, Girardis Massimo, Guaraldi Giovanni, Mussini Cristina
Infectious Diseases Clinic, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.
University of Modena and Reggio Emilia, Italy.
Infez Med. 2021 Dec 10;29(4):538-549. doi: 10.53854/liim-2904-6. eCollection 2021.
Cardiovascular complications after a SARS-CoV-2 infection are a phenomenon of relevant scientific interest. The aim of this study was to analyze the onset of post-COVID-19 cardiovascular events in patients hospitalized in a tertiary care center. This is a retrospective study conducted on patients hospitalized over a period of three months. The patients were older than 18 years of age and had a diagnosis of COVID-19 infection confirmed from a nasopharyngeal swab sample. Anamnestic and clinical-laboratory data were collected. Cardiovascular events at 30 days were defined as follows: arrhythmias, myocardial infarction, myocarditis, and pulmonary embolism. Univariate analysis (Student's t-test or Mann-Whitney U test, as appropriate) and multivariate analysis (multinomial logistic regression) were applied to the data. A total of 394 patients were included; they were mostly males and had a median age of 65.5 years. Previous cardiovascular disease was present in 14.7% of patients. Oxygen therapy was required for 77.9%, and 53% received anticoagulant therapy. The overall 30-day mortality was 20.3%. A cardiovascular event developed in 15.7% of the subjects. These were mainly pulmonary embolism (9.4%), followed by arrhythmias (3.3%), myocardial infarction (2.3%), and myocarditis (0.8%). Patients who developed cardiovascular events upon univariate analysis were significantly older, with major comorbidities, a more compromised respiratory situation, and a higher mortality rate. Multivariate analysis revealed independent factors that were significantly associated with the development of cardiovascular events: hypertension, endotracheal intubation, and age older than 75 years. In patients with COVID-19, the development of a cardiovascular event occurs quite frequently and is mainly seen in elderly subjects with comorbidities (especially hypertension) in the presence of a severe respiratory picture.
新型冠状病毒2型（SARS-CoV-2）感染后的心血管并发症是一个具有重要科学研究价值的现象。本研究的目的是分析在一家三级医疗中心住院的患者中新冠病毒病（COVID-19）后心血管事件的发生情况。这是一项对三个月内住院患者进行的回顾性研究。患者年龄大于18岁，且经鼻咽拭子样本确诊为COVID-19感染。收集了既往史和临床实验室数据。30天时的心血管事件定义如下：心律失常、心肌梗死、心肌炎和肺栓塞。对数据应用单因素分析（根据情况采用Student t检验或Mann-Whitney U检验）和多因素分析（多项逻辑回归）。共纳入394例患者；他们大多为男性，中位年龄为65.5岁。14.7%的患者既往有心血管疾病。77.9%的患者需要氧疗，53%的患者接受抗凝治疗。30天总体死亡率为20.3%。15.7%的受试者发生了心血管事件。这些事件主要是肺栓塞（9.4%），其次是心律失常（3.3%）、心肌梗死（2.3%）和心肌炎（0.8%）。单因素分析中发生心血管事件的患者年龄显著更大，有主要合并症，呼吸状况更差，死亡率更高。多因素分析揭示了与心血管事件发生显著相关的独立因素：高血压、气管插管和年龄大于75岁。在COVID-19患者中，心血管事件的发生相当频繁，主要见于患有合并症（尤其是高血压）且存在严重呼吸道症状的老年患者。
