Related Experiment Video
Updated: Oct 20, 2025
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Prognostic Impact of Acute Cardiovascular Events in COVID-19 Hospitalized Patients-Results from the CORONA Germany
Melanie A Gunawardene1, Nele Gessler1,2,3, Peter Wohlmuth2
1Department of Cardiology and Internal Intensive Care Medicine, Asklepios Hospital St. Georg, 20099 Hamburg, Germany.
Insights
Hospitalized COVID-19 patients experiencing acute cardiovascular events face significantly higher mortality. Arrhythmias are a key factor contributing to these adverse outcomes in coronavirus disease 2019 patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Epidemiology
Background:
- Acute myocardial injury (AMJ) in COVID-19 is linked to mortality.
- The impact of clinically apparent acute cardiovascular (CV) events in hospitalized COVID-19 patients remains unclear.
Purpose of the Study:
- To investigate the occurrence and impact of acute, clinically manifest CV events in hospitalized COVID-19 patients.
Main Methods:
- A multicenter, prospective epidemiological cohort study was conducted across six hospitals in Hamburg, Germany.
- The study enrolled hospitalized COVID-19 patients between March 2020 and January 2021.
- The primary endpoint was the incidence of clinically manifest CV events.
Main Results:
- 132 CV events occurred in 92 out of 414 (22.2%) patients.
- Mortality was 46% for patients with CV events versus 33% for those with only AMJ.
- Patients with CV events had a 4.8-fold increased mortality risk; arrhythmias were a major determinant.
Conclusions:
- Clinically evident acute cardiovascular events significantly increase mortality in hospitalized COVID-19 patients.
- Arrhythmias emerge as a critical factor driving mortality in this population.
Background:
Acute myocardial injury (AMJ), assessed by elevated levels of cardiac troponin, is associated with fatal outcome in coronavirus disease 2019 (COVID-19). However, the role of acute cardiovascular (CV) events defined by clinical manifestation rather than sole elevations of biomarkers is unclear in hospitalized COVID-19 patients.
Objective:
The aim of this study was to investigate acute clinically manifest CV events in hospitalized COVID-19 patients.
Methods:
From 1 March 2020 to 5 January 2021, we conducted a multicenter, prospective, epidemiological cohort study at six hospitals from Hamburg, Germany (a portion of the state-wide 45-center CORONA Germany cohort study) enrolling all hospitalized COVID-19 patients. Primary endpoint was occurrence of a clinically manifest CV-event.
Results:
In total, 132 CV-events occurred in 92 of 414 (22.2%) patients in the Hamburg-cohort: cardiogenic shock in 10 (2.4%), cardiopulmonary resuscitation in 12 (2.9%), acute coronary syndrome in 11 (2.7%), de-novo arrhythmia in 31 (7.5%), acute heart-failure in 43 (10.3%), myocarditis in 2 (0.5%), pulmonary-embolism in 11 (2.7%), thrombosis in 9 (2.2%) and stroke in 3 (0.7%). In the Hamburg-cohort, mortality was 46% (42/92) for patients with a CV-event and 33% (27/83) for patients with only AMJ without CV-event (OR 1.7, CI: (0.94-3.2), p = 0.077). Mortality was higher in patients with CV-events (Odds ratio(OR): 4.8, 95%-confidence-interval(CI): [2.9-8]). Age (OR 1.1, CI: (0.66-1.86)), atrial fibrillation (AF) on baseline-ECG (OR 3.4, CI: (1.74-6.8)), systolic blood-pressure (OR 0.7, CI: (0.53-0.96)), potassium (OR 1.3, CI: (0.99-1.73)) and C-reactive-protein (1.4, CI (1.04-1.76)) were associated with CV-events.
Conclusion:
Hospitalized COVID-19 patients with clinical manifestation of acute cardiovascular events show an almost five-fold increased mortality. In this regard, the emergence of arrhythmias is a major determinant.
More Related Videos
03:13Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research
Published on: November 3, 2023
05:16Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome I: Introduction
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:30Coronary Artery Disease III: Clinical Manifestations