Department of Clinical and Molecular Medicine, Sapienza University of Rome, Via di Grottarossa 1035-1039, Rome 00189, Italy.
Cardiology Department, IRCCS San Raffaele Roma, Via di Valcannuta 250, Rome 00166, Italy.
Cardiovasc Res. 2024 May 7;120(6):623-629. doi: 10.1093/cvr/cvae049.
We evaluated the incidence and relative risk of major post-acute cardiovascular consequences of SARS-CoV-2 infection in a large real-world population from a primary care database in a region at moderate cardiovascular risk followed up in the period 2020-22.
This is a retrospective cohort analysis using data from a cooperative of general practitioners in Italy. Individuals aged >18 affected by COVID-19 starting from January 2020 have been followed up for 3 years. Anonymized data from 228 266 patients in the period 2020-22 were considered for statistical analysis and included 31 764 subjects with a diagnosis of COVID-19. An equal group of subjects recorded in the same database in the period 2017-19 was used as propensity score-matched comparison as an unquestionable COVID-19-free population. Out of the 228 266 individuals included in the COMEGEN database during 2020-22, 31 764 (13.9%) were ascertained positive with SARS-CoV-2 infection by a molecular test reported to general practitioners. The proportion of individuals with a new diagnosis of major adverse cardiovascular and cerebrovascular events was higher in the 2020-22 COVID-19 group than in the 2017-19 COMEGEN propensity score-matched comparator, with an odds ratio of 1.73 (95% confidence interval: 1.53-1.94; P < 0.001). All major adverse cardiovascular and cerebrovascular events considered showed a significantly higher risk in COVID-19 individuals. Incidence calculated for each 6-month period after the diagnosis of COVID-19 in our population was the highest in the first year (1.39% and 1.45%, respectively), although it remained significantly higher than in the COVID-19-free patients throughout the 3 years.
The increase of cardiovascular risk associated with COVID-19 might be extended for years and not limited to the acute phase of the infection. This should promote the planning of longer follow-up for COVID-19 patients to prevent and promptly manage the potential occurrence of major adverse cardiovascular and cerebrovascular events.
我们评估了在 2020-22 年期间，从意大利初级保健医生合作数据库中一个中等心血管风险地区的大样本真实世界人群中，SARS-CoV-2 感染后主要急性心血管后果的发生率和相对风险。
这是一项使用意大利合作的全科医生数据进行的回顾性队列分析。从 2020 年 1 月开始，年龄大于 18 岁的感染 COVID-19 的个体被随访 3 年。2020-22 年期间，从数据库中分析了 228266 名患者的匿名数据，其中 31764 名患者被诊断为 COVID-19。同期数据库中作为倾向评分匹配比较的相同人数的患者被用作无可置疑的 COVID-19 无患者组。在 2020-22 年期间的 COMEGEN 数据库中，有 228266 名患者，其中 31764 名（13.9%）通过向全科医生报告的分子检测确定 SARS-CoV-2 感染阳性。与 2017-19 年的 COMEGEN 倾向评分匹配对照组相比，2020-22 年 COVID-19 组中，新发主要不良心血管和脑血管事件的患者比例更高，比值比为 1.73（95%置信区间：1.53-1.94；P<0.001）。考虑到的所有主要不良心血管和脑血管事件在 COVID-19 患者中均显示出更高的风险。在我们的人群中，COVID-19 诊断后每 6 个月计算的发病率在第一年最高（分别为 1.39%和 1.45%），尽管在 3 年内仍明显高于 COVID-19 无患者。
与 COVID-19 相关的心血管风险增加可能会持续数年，而不仅仅局限于感染的急性期。这应该促进对 COVID-19 患者进行更长时间的随访，以预防和及时管理潜在的主要不良心血管和脑血管事件的发生。
