Renda Giulia, Ricci Fabrizio, Spinoni Enrico Guido, Grisafi Leonardo, D'Ardes Damiano, Mennuni Marco, Tana Claudio, Rognoni Andrea, Bellan Mattia, Sainaghi Pier Paolo, Pirisi Mario, De Vecchi Simona, Gallina Sabina, Pierdomenico Sante Donato, Cipollone Francesco, Patti Giuseppe
Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.
SS. Annunziata Hospital of Chieti, 66100 Chieti, Italy.
J Clin Med. 2022 Jan 29;11(3):729. doi: 10.3390/jcm11030729.
Clinical outcome data of patients discharged after Coronavirus disease 2019 (COVID-19) are limited and no study has evaluated predictors of cardiovascular prognosis in this setting. Our aim was to assess short-term mortality and cardiovascular outcome after hospitalization for COVID-19. A prospective cohort of 296 consecutive patients discharged after COVID-19 from two Italian institutions during the first wave of the pandemic and followed up to 6 months was included. The primary endpoint was all-cause mortality. The co-primary endpoint was the incidence of the composite outcome of major adverse cardiac and cerebrovascular events (MACCE: cardiovascular death, myocardial infarction, stroke, pulmonary embolism, acute heart failure, or hospitalization for cardiovascular causes). The mean follow-up duration was 6 ± 2 months. The incidence of all-cause death was 4.7%. At multivariate analysis, age was the only independent predictor of mortality (aHR 1.08, 95% CI 1.01-1.16). MACCE occurred in 7.2% of patients. After adjustment, female sex (aHR 2.6, 95% CI 1.05-6.52), in-hospital acute heart failure during index hospitalization (aHR 3.45, 95% CI 1.19-10), and prevalent atrial fibrillation (aHR 3.05, 95% CI 1.13-8.24) significantly predicted the incident risk of MACCE. These findings may help to identify patients for whom a closer and more accurate surveillance after discharge for COVID-19 should be considered.
2019年冠状病毒病（COVID-19）出院患者的临床结局数据有限，尚无研究评估这种情况下心血管预后的预测因素。我们的目的是评估COVID-19住院后的短期死亡率和心血管结局。纳入了在疫情第一波期间从意大利两家机构连续出院的296例COVID-19患者的前瞻性队列，并随访了6个月。主要终点是全因死亡率。共同主要终点是主要不良心脑血管事件（MACCE：心血管死亡、心肌梗死、中风、肺栓塞、急性心力衰竭或因心血管原因住院）复合结局的发生率。平均随访时间为6±2个月。全因死亡发生率为4.7%。在多变量分析中，年龄是死亡率的唯一独立预测因素（调整后风险比[aHR]1.08，95%置信区间[CI]1.01-1.16）。7.2%的患者发生了MACCE。调整后，女性（aHR 2.6，95%CI 1.05-6.52）、首次住院期间的院内急性心力衰竭（aHR 3.45，95%CI 1.19-10）和既往房颤（aHR 3.05，95%CI 1.13-8.24）显著预测了MACCE的发生风险。这些发现可能有助于确定对于哪些COVID-19出院患者应考虑进行更密切、更准确的监测。
