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长新冠和心血管疾病:一项前瞻性队列研究。

Long COVID and cardiovascular disease: a prospective cohort study.

机构信息

Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.

Department of Haemostasis and Thrombosis, Glasgow Royal Infirmary, Glasgow, Glasgow, UK.

出版信息

Open Heart. 2024 May 27;11(1):e002662. doi: 10.1136/openhrt-2024-002662.

Abstract

BACKGROUND

Pre-existing cardiovascular disease (CVD) or cardiovascular risk factors have been associated with an increased risk of complications following hospitalisation with COVID-19, but their impact on the rate of recovery following discharge is not known.

OBJECTIVES

To determine whether the rate of patient-perceived recovery following hospitalisation with COVID-19 was affected by the presence of CVD or cardiovascular risk factors.

METHODS

In a multicentre prospective cohort study, patients were recruited following discharge from the hospital with COVID-19 undertaking two comprehensive assessments at 5 months and 12 months. Patients were stratified by the presence of either CVD or cardiovascular risk factors prior to hospitalisation with COVID-19 and compared with controls with neither. Full recovery was determined by the response to a patient-perceived evaluation of full recovery from COVID-19 in the context of physical, physiological and cognitive determinants of health.

RESULTS

From a total population of 2545 patients (38.8% women), 472 (18.5%) and 1355 (53.2%) had CVD or cardiovascular risk factors, respectively. Compared with controls (n=718), patients with CVD and cardiovascular risk factors were older and more likely to have had severe COVID-19. Full recovery was significantly lower at 12 months in patients with CVD (adjusted OR (aOR) 0.62, 95% CI 0.43 to 0.89) and cardiovascular risk factors (aOR 0.66, 95% CI 0.50 to 0.86).

CONCLUSION

Patients with CVD or cardiovascular risk factors had a delayed recovery at 12 months following hospitalisation with COVID-19. Targeted interventions to reduce the impact of COVID-19 in patients with cardiovascular disease remain an unmet need.

TRAIL REGISTRATION NUMBER

ISRCTN10980107.

摘要

背景

先前存在的心血管疾病(CVD)或心血管危险因素与 COVID-19 住院后发生并发症的风险增加有关,但它们对出院后恢复速度的影响尚不清楚。

目的

确定 COVID-19 住院后患者自我感知的恢复速度是否受 CVD 或心血管危险因素的影响。

方法

在一项多中心前瞻性队列研究中,COVID-19 出院后的患者接受了两次全面评估,分别在 5 个月和 12 个月时进行。根据 COVID-19 住院前是否存在 CVD 或心血管危险因素对患者进行分层,并与既无 CVD 也无心血管危险因素的对照组进行比较。完全恢复是通过在健康的生理、心理和认知决定因素的背景下,对 COVID-19 完全恢复的患者自我感知评估的反应来确定的。

结果

在总共 2545 名患者(38.8%为女性)中,分别有 472 名(18.5%)和 1355 名(53.2%)患有 CVD 或心血管危险因素。与对照组(n=718)相比,患有 CVD 和心血管危险因素的患者年龄更大,且更有可能患有严重 COVID-19。患有 CVD 的患者在 12 个月时完全恢复的比例明显较低(校正优势比[aOR]0.62,95%CI 0.43 至 0.89),心血管危险因素(aOR 0.66,95%CI 0.50 至 0.86)。

结论

COVID-19 住院后,患有 CVD 或心血管危险因素的患者在 12 个月时恢复较慢。针对减少 COVID-19 对心血管疾病患者影响的靶向干预措施仍然是一个未满足的需求。

临床试验注册号

ISRCTN83422643。

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