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From Crisis to Complications: A Nationwide Cohort Study Assessing One-Year Cardiovascular and Thromboembolic Risks

Andreas Liliequist1,2, Per Svensson3, Robin Hofmann3

  • 1Department of Medicine, Solna, Karolinska Institutet, 171 64 Stockholm, Sweden.

Journal of Clinical Medicine
|December 17, 2024
PubMed

Insights

Patients with severe COVID-19 requiring intensive care face a significantly higher risk of cardiovascular and thrombotic events, including atherosclerotic cardiovascular disease (ASCVD) and venous thromboembolism, within one year post-discharge.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Long-term risks of cardiovascular and thrombotic events post-severe COVID-19 are not well-established.
  • Severe COVID-19 necessitates intensive care, often involving mechanical ventilation.
  • Understanding post-discharge risks is crucial for patient management and public health strategies.

Purpose of the Study:

  • To evaluate the one-year risk of atherosclerotic cardiovascular disease (ASCVD) after hospital discharge in severe COVID-19 survivors.
  • To assess secondary outcomes including myocardial infarction, stroke, all-cause mortality, and venous thromboembolic events.
  • To quantify the association between severe COVID-19 and post-discharge cardiovascular and thrombotic risks.

Main Methods:

  • Nationwide, register-based case-control study design.
  • Inclusion of severe COVID-19 patients requiring mechanical ventilation, matched with population controls.
  • Primary outcome: ASCVD (composite of myocardial infarction, unstable angina, ischemic stroke); Secondary outcomes: MI, stroke, mortality, VTE.

Main Results:

  • A total of 31,375 individuals (2,854 severe COVID-19 cases, 26,885 controls) were analyzed.
  • Adjusted Hazard Ratio (HR) for ASCVD within one year was 3.1 (95% CI 1.7-5.4).
  • Significantly elevated HRs for pulmonary embolism (49.4) and deep venous thrombosis (16.0) were observed.

Conclusions:

  • Severe COVID-19 requiring intensive care is linked to a substantially increased one-year risk of ASCVD.
  • A significant rise in venous thromboembolic events (VTE) was noted in severe COVID-19 survivors.
  • Findings highlight the need for vigilant cardiovascular monitoring in patients recovering from critical COVID-19.

Keywords:
COVID-19cardiovascular eventsintensive carelong term outcome

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