Øvrebotten Tarjei, Tholin Birgitte, Berge Kristian, Myhre Peder Langeland, Stavem Knut
Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
University of Oslo, Oslo, Norway.
Open Heart. 2025 Feb 4;12(1):e002914. doi: 10.1136/openhrt-2024-002914.
Studies have shown an increased risk of cardiac disease following COVID-19, but how it compares to pneumonia of other etiologies is unclear.
To determine the incidence and HRs of cardiac disease in patients hospitalised with COVID-19 compared with other viral or bacterial pneumonias.
Using nationwide registry data, we estimated the incidence of cardiac events after hospitalisation with COVID-19 (n=2082) in February to November 2020 vs hospitalisation with viral (n=9018) or bacterial (n=29 339) pneumonia in 2018-2019. We defined outcomes using ICD-10 codes for incident myocarditis, acute myocardial infarction, atrial fibrillation/flutter, heart failure, ischaemic heart disease, other cardiac disease and total cardiac disease (any heart condition). We used Cox regression and logistic regression for analysis.
Patients with COVID-19 had a mean (SD) age of 60 (18) years, compared with 69 (19) years for viral and 72 (17) years for bacterial pneumonia. Those with COVID-19 were more often male and had fewer comorbidities and fewer prior hospitalisations. Patients with COVID-19 had a lower hazard of new-onset cardiac disease compared with viral (HR 0.79 [95%CI 0.66 to 0.93]) and bacterial pneumonia (HR 0.66 [95%CI 0.57 to 0.78]), adjusted for age, sex, comorbidity, hospital admission prior year and respiratory support. Results were similar when including recurrent events.
Patients hospitalised with COVID-19 had a lower hazard of new-onset cardiac disease during the first 9 months after hospitalisation compared with patients with other viral or bacterial pneumonias after adjusting for multiple possible confounders. However, there may still be residual confounding from other or unknown factors.
研究表明，感染新型冠状病毒肺炎（COVID-19）后心脏病风险增加，但与其他病因所致肺炎相比情况如何尚不清楚。
确定COVID-19住院患者与其他病毒或细菌性肺炎患者相比心脏病的发病率及风险比（HRs）。
利用全国登记数据，我们估计了2020年2月至11月COVID-19住院患者（n = 2082）与2018 - 2019年病毒（n = 9018）或细菌性肺炎（n = 29339）住院患者心脏病事件的发生率。我们使用国际疾病分类第十版（ICD - 10）编码定义新发心肌炎、急性心肌梗死、心房颤动/扑动、心力衰竭、缺血性心脏病、其他心脏病及总心脏病（任何心脏疾病）的结局。我们采用Cox回归和逻辑回归进行分析。
COVID-19患者的平均（标准差）年龄为60（18）岁，而病毒肺炎患者为69（19）岁，细菌性肺炎患者为72（17）岁。COVID-19患者男性更多，合并症更少，既往住院次数更少。在调整年龄、性别、合并症、上一年住院情况及呼吸支持后，COVID-19患者新发心脏病的风险低于病毒肺炎（HR 0.79 [95%置信区间0.66至0.93]）和细菌性肺炎（HR 0.66 [95%置信区间0.57至0.78]）。纳入复发事件时结果相似。
在调整多种可能的混杂因素后，与其他病毒或细菌性肺炎患者相比，COVID-19住院患者在住院后的前9个月内新发心脏病的风险较低。然而，可能仍存在其他或未知因素导致的残余混杂。
