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Post-recovery COVID-19 and incident heart failure in the National COVID Cohort Collaborative (N3C) study
Husam M Salah1, Marat Fudim2,3, Shawn T O'Neil4
1Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Insights
Hospitalization for COVID-19 significantly increases the risk of developing new-onset heart failure. This risk is elevated even after recovery, highlighting a critical post-infection concern.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Cardiac complications are recognized in COVID-19.
- The long-term risk of de novo heart failure post-COVID-19 remains understudied in large populations.
Purpose of the Study:
- To investigate the association between COVID-19 hospitalization and the subsequent development of new-onset heart failure.
- To analyze risk factors and demographic variations in heart failure incidence after COVID-19.
Main Methods:
- Retrospective cohort study using the National COVID Cohort Collaborative (N3C) data.
- Analysis of 587,330 hospitalized patients (257,075 with COVID-19, 330,255 without).
- Median follow-up of 367 days, with adjusted hazard ratios calculated.
Main Results:
- COVID-19 hospitalization was linked to a 45% increased hazard of incident heart failure (HR=1.45).
- Increased risk was more pronounced in younger patients, White patients, and those with pre-existing cardiovascular disease.
- 10,979 new heart failure events were recorded during the follow-up period.
Conclusions:
- Hospitalization for COVID-19 is an independent risk factor for developing incident heart failure.
- Specific patient subgroups may face a disproportionately higher risk.
- Findings underscore the importance of cardiac monitoring post-COVID-19 hospitalization.
Abstract:
Cardiac involvement has been noted in COVID-19 infection. However, the relationship between post-recovery COVID-19 and development of de novo heart failure has not been investigated in a large, nationally representative population. We examined post-recovery outcomes of 587,330 patients hospitalized in the United States (257,075 with COVID-19 and 330,255 without), using data from the National COVID Cohort Collaborative study. Patients hospitalized with COVID-19 were older (51 vs. 46 years), more often male (49% vs. 42%), and less often White (61% vs. 69%). Over a median follow up of 367 days, 10,979 incident heart failure events occurred. After adjustments, COVID-19 hospitalization was associated with a 45% higher hazard of incident heart failure (hazard ratio = 1.45; 95% confidence interval: 1.39-1.51), with more pronounced associations among patients who were younger (P-interaction = 0.003), White (P-interaction = 0.005), or who had established cardiovascular disease (P-interaction = 0.005). In conclusion, COVID-19 hospitalization is associated with increased risk of incident heart failure.
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