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Impact of Cardiac and Cerebrovascular Complications During Hospitalization on Long-Term Prognosis in Patients With
Kazuya Tateishi1, Hosam Hmoud2, Lucius De Gregorio3
1Department of Cardiovascular Services, Englewood Hospital and Medical Center, Englewood, New Jersey.
Insights
Myocardial infarction during COVID-19 hospitalization significantly increases long-term mortality risk in survivors. Cerebrovascular accidents and pulmonary embolisms did not show a significant impact on long-term survival.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Long-term prognosis after COVID-19 hospitalization is not fully understood.
- Cardiac and cerebrovascular events during hospitalization may influence outcomes.
Purpose of the Study:
- To assess the impact of myocardial infarction (MI), cerebrovascular accident (CVA), and pulmonary embolism (PE) during COVID-19 hospitalization on long-term survival.
Main Methods:
- Retrospective analysis of 2,389 COVID-19 survivors hospitalized between January and June 2020.
- Patients were grouped based on the occurrence of MI, CVA, or PE during hospitalization.
- Long-term survival post-discharge was the primary outcome, with a median follow-up of 2.4 years.
Main Results:
- Myocardial infarction during hospitalization was linked to a significantly higher risk of all-cause death (HR 2.45, p <0.001).
- Patients with MI had a 27.0% mortality rate compared to 6.2% in the non-MI group (p <0.001).
- Cerebrovascular accident and pulmonary embolism were not significantly associated with increased long-term mortality.
Conclusions:
- Myocardial infarction during COVID-19 hospitalization is an independent predictor of long-term mortality.
- Cerebrovascular accident and pulmonary embolism during hospitalization do not appear to significantly affect long-term survival post-discharge.
Abstract:
The impact of cardiac and cerebrovascular events during COVID-19 hospitalization on long-term prognosis remains uncertain. We aimed to evaluate the effect of myocardial infarction (MI), cerebrovascular accident (CVA), and pulmonary embolism (PE) during hospitalization on the long-term prognosis in patients who survived COVID-19 hospitalization. A retrospective observational analysis was performed on a cohort of 2,389 patients who survived COVID-19 hospitalization in our institution between January and June 2020. The patients were divided into MI (n = 111) and non-MI (n = 2,278) groups according to the presence of MI during hospitalization. As a subanalysis, the patients were assigned to CVA (n = 97) and non-CVA (n = 2,292) and PE (n = 54) and non-PE (n = 2,335) groups. The primary outcome was long-term survival after discharge. During a median follow-up period of 2.4 years after discharge, 30 patients (27.0%) in the MI group and 140 patients (6.2%) in the non-MI group died (p <0.001). The Kaplan-Meier survival curve analysis demonstrated that the MI group was significantly associated with an increased incidence of all-cause death after discharge (log-rank p <0.001), as supported by the multivariate Cox proportional hazards model analysis (hazard ratio [HR] 2.45, 95% confidence interval [CI] 1.61 to 3.74, p <0.001). However, the presence of CVA (HR 1.46, 95% CI 0.91 to 2.34, p = 0.113) or PE (HR 0.94, 95% CI 0.23 to 3.84, p = 0.937) were not associated with an increased incidence of all-cause death after discharge. In conclusion, among the cardiovascular and cerebrovascular complications associated with COVID-19 hospitalization, the presence of MI during hospitalization was proved to be a significant independent predictor of long-term mortality in patients who survived COVID-19 hospitalization.
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