在一般人群中预测COVID-19后心血管疾病的发病率和个人风险:一个多变量预测模型开发和验证研究
Hannah M la Roi-Teeuw1, Maarten van Smeden2,3, Geert-Jan Geersing1
1Department of General Practice and Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, 3584 CX, Utrecht, The Netherlands.
心血管风险,包括血栓和心房动,在COVID-19感染后60天内增加. 虽然预测模型的准确性很高,但绝对风险仍然很低,限制了个人风险管理指导.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 以前的研究表明,COVID-19感染后心血管风险增加.
- 了解这些风险的确切时间和规模对于患者管理至关重要.
研究的目的:
- 评估COVID-19感染后心血管疾病的发生率.
- 探索个人风险因素和COVID-19后心血管事件的时间关系.
主要方法:
- 使用英国临床实践研究数据链接来提取数据.
- 估计发生率为动脉/静脉事件,炎症性心脏病,心房动和心力衰竭在感染后180天内.
- 在大型接种疫苗和未接种疫苗的队列中开发和外部验证了多变量后勤回归模型.
主要成果:
- 在COVID-19后60天内观察到静脉/动脉心血管事件和新发性心房的发病率增加.
- 静脉事件的最高发病率 (13每1000人年).
- 预测模型显示了高的区分性表现 (c-统计≥0.90),但<5%的个体在180天内预测风险>1%.
结论:
- COVID-19感染增加了动脉/静脉心血管事件和60天内新发性心房的风险.
- 尽管模式歧视很高,但绝对风险低使个体风险分层和管理决策复杂化.
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