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[Cardiovascular disease before and after COVID-19 infection: One-year survival]
M C de Diego-Castell1, E García-López2, J A Álvarez-Gregori3
1Medicina Familiar y Comunitaria, Centro de Salud Santa Olalla, Toledo, España; Gerencia de Atención Integrada (GAI) de Talavera de la Reina, Servicio de Salud de Castilla-La Mancha (SESCAM), Toledo, España; Programa de Doctorado en Ciencias de la Salud, Universidad Castilla-La Mancha (UCLM), Castilla-La Mancha, España.
Insights
Previous cardiovascular events (CVE) increase COVID-19 risk in men, while diabetes and cognitive impairment raise risk in women. COVID-19 infection and prior CVE predict new cardiovascular events, impacting survival.
Area of Science:
- Cardiology and Infectious Diseases
- Epidemiology and Public Health
Context:
- The COVID-19 pandemic has highlighted the significant impact of pre-existing conditions on disease outcomes.
- Understanding the interplay between cardiovascular health and COVID-19 is crucial for risk stratification and patient management.
Purpose:
- To investigate the association between pre-existing morbidities and the risk of contracting COVID-19.
- To determine the risk of new cardiovascular events (CVE) in patients with COVID-19.
- To analyze one-year survival rates in COVID-19 patients.
Summary:
- A case-control and prospective cohort study analyzed 275 COVID-19 patients and 825 controls.
- Previous CVE doubled COVID-19 risk in men. In women, age, diabetes (DM), and cognitive impairment increased risk.
- Age, arterial hypertension, prior CVE, and COVID-19 infection predicted new CVE. COVID-19 patients had significantly lower one-year survival.
Impact:
- Identifies specific risk factors for COVID-19 acquisition based on sex and comorbidities.
- Provides critical data on the increased risk of cardiovascular events post-COVID-19 infection.
- Highlights the long-term survival implications of COVID-19, particularly in individuals with cardiovascular disease.
Aim:
To analyze the risk of COVID-19 in relation to previous morbidity; to analyze the risk of new cardiovascular events (CVE) in COVID-19 patients and one-year survival.
Methodology:
Case-control study and prospective cohort study. Two hundred and seventy-five randomized patients >18 years old with COVID-19 were included and matched with 825 without COVID-19 by age and sex (ratio 1:3). The main variables were diagnosis of COVID-19 and post-COVID-19 events. Sociodemographic variables, comorbidity, and previous CVD were studied. Two predictive models of factors associated with the development of COVID-19 and post-COVID-19 CVE were performed, as well as a one-year survival analysis.
Results:
Men with a previous CVE double the risk of suffering from COVID-19 (OR 2.11; 95% CI: 1.32-3.36). In women, the risk increases with age (OR 1.01; 95% CI: 1.00-1.02), diabetes (DM) (OR 1.90; 95% CI: 1.14-3.17) and cognitive impairment (OR 4.88; 95% CI: 2.50-9.53). Immunosuppression acts as a protective factor in both sexes. Age (OR 1.02; 95% CI: 1.00-1.04), arterial hypertension (OR 2.21; 95% CI: 1.17-4.17), COVID-19 infection (OR 4.81; 95% CI: 2.89-7.98) and previous CVE (OR 4.46; 95% CI: 2.56-7.75) predict the development of a new post-COVID-19 CVE. Positive COVID-19 has lower survival (median 7 days vs. 184 days).
Conclusions:
Previous CVE in men and DM along with cognitive impairment in women increase the risk of presenting COVID-19. Age, arterial hypertension, previous CVE, and COVID-19 infection predict the appearance of new CVE.
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