Núñez-Gil Ivan J, Feltes Gisela, Viana-Llamas María C, Raposeiras-Roubin Sergio, Romero Rodolfo, Alfonso-Rodríguez Emilio, Uribarri Aitor, Santoro Francesco, Becerra-Muñoz Víctor, Pepe Martino, Castro-Mejía Alex F, Signes-Costa Jaime, Gonzalez Adelina, Marín Francisco, Lopez-País Javier, Cerrato Enrico, Vázquez-Cancela Olalla, Espejo-Paeres Carolina, López Masjuan Álvaro, Velicki Lazar, El-Battrawy Ibrahim, Ramakrishna Harish, Fernandez-Ortiz Antonio, Perez-Villacastín Julián
Cardiology Department, Hospital Clínico San Carlos, 28040 Madrid, Spain.
Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain.
J Clin Med. 2023 Jan 16;12(2):706. doi: 10.3390/jcm12020706.
Heart disease is linked to worse acute outcomes after coronavirus disease 2019 (COVID-19), although long-term outcomes and prognostic factor data are lacking. We aim to characterize the outcomes and the impact of underlying heart diseases after surviving COVID-19 hospitalization.
We conducted an analysis of the prospective registry HOPE-2 (Health Outcome Predictive Evaluation for COVID-19-2, NCT04778020). We selected patients discharged alive and considered the primary end-point all-cause mortality during follow-up. As secondary main end-points, we included any readmission or any post-COVID-19 symptom. Clinical features and follow-up events are compared between those with and without cardiovascular disease. Factors with < 0.05 in the univariate analysis were entered into the multivariate analysis to determine independent prognostic factors.
HOPE-2 closed on 31 December 2021, with 9299 patients hospitalized with COVID-19, and 1805 died during this acute phase. Finally, 7014 patients with heart disease data were included in the present analysis, from 56 centers in 8 countries. Heart disease (+) patients were older (73 vs. 58 years old), more frequently male (63 vs. 56%), had more comorbidities than their counterparts, and suffered more frequently from post-COVID-19 complications and higher mortality (OR : 2.63, 95% CI: 1.81-3.84). Vaccination was found to be an independent protector factor (HR : 0.09; 95% CI: 0.04-0.19).
After surviving the acute phase, patients with underlying heart disease continue to present a more complex clinical profile and worse outcomes including increased mortality. The COVID-19 vaccine could benefit survival in patients with heart disease during follow-up.
尽管缺乏长期预后和预后因素数据，但心脏病与2019冠状病毒病（COVID-19）后的更差急性结局相关。我们旨在描述COVID-19住院存活后潜在心脏病的结局及其影响。
我们对前瞻性登记处HOPE-2（COVID-19-2的健康结局预测评估，NCT04778020）进行了分析。我们选择了存活出院的患者，并将随访期间的全因死亡率作为主要终点。作为次要主要终点，我们纳入了任何再入院或任何COVID-19后症状。比较有心血管疾病和无心血管疾病患者的临床特征和随访事件。单因素分析中P<0.05的因素纳入多因素分析以确定独立预后因素。
HOPE-2于2021年12月31日结束，共有9299例COVID-19住院患者，其中1805例在急性期死亡。最终，本分析纳入了来自8个国家56个中心的7014例有心脏病数据的患者。有心脏病（+）的患者年龄更大（73岁对58岁），男性比例更高（63%对56%），合并症更多，COVID-19后并发症更多，死亡率更高（OR：2.63，95%CI：1.81-3.84）。发现接种疫苗是一个独立的保护因素（HR：0.09；95%CI：0.04-0.19）。
在急性期存活后，潜在心脏病患者的临床情况仍然更复杂，结局更差，包括死亡率增加。COVID-19疫苗可能有利于心脏病患者随访期间的生存。
