Viviana Maestrini1, Lucia Ilaria Birtolo1, Marco Francone2, Gioacchino Galardo3, Nicola Galea4, Paolo Severino1, Francesco Alessandri5, Maria Chiara Colaiacomo6, Giulia Cundari4, Cristina Chimenti1, Carlo Lavalle1, Maria Ciardi7, Paolo Palange8, Alberto Deales9, Gabriella d'Ettorre7, Claudio M Mastroianni7, Carlo Catalano4, Franco Ruberto5, Francesco Pugliese5, Giulia d'Amati4, Francesco Fedele1, Massimo Mancone10. 1. Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, "Policlinico Umberto I" Hospital, Rome, Italy. 2. Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, "Policlinico Umberto I" Hospital, Rome, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy. 3. Emergency Department, "Policlinico Umberto I" Hospital, Rome, Italy. 4. Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, "Policlinico Umberto I" Hospital, Rome, Italy. 5. Department of Anaesthesia and Intensive Care Medicine, Sapienza University of Rome, "Policlinico Umberto I" Hospital, Rome, Italy. 6. Radiology DEA Department, Sapienza University of Rome, "Policlinico Umberto I" Hospital, Rome, Italy. 7. Department of Public Health and Infectious Diseases, Sapienza University of Rome, "Policlinico Umberto I" Hospital, Rome, Italy. 8. Department of Public Health and Infectious Diseases, Division of Pulmonary Medicine, Sapienza University of Rome, "Policlinico Umberto I" Hospital, Rome, Italy. 9. Sapienza University Hospital "Policlinico Umberto I", Rome, Italy. 10. Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, "Policlinico Umberto I" Hospital, Rome, Italy. Electronic address: massimo.mancone@uniroma1.it.
Abstract
BACKGROUND: Cardiovascular disease (CVD) can occur in COVID-19 and has impact on clinical course. Data on CVD prevalence in hospitalized COVID-19 patients and sequelae in survivors is limited. Aim of this prospective study carried out on consecutive unselected COVID-19 population, was to assess: 1) CVD occurrence among hospitalized COVID-19 patients, 2) persistence or new onset of CVD at one-month and one-year follow-up. METHODS: Over 30 days n = 152 COVID-19 patients underwent cardiovascular evaluation. Standard electrocardiogram (ECG), Troponin and echocardiography were integrated by further tests when indicated. Medical history, arterial blood gas, blood tests, chest computed tomography and treatment were recorded. CVD was defined as the occurrence of a new condition during the hospitalization for COVID-19. Survivors attended a one-month follow-up visit and a one-year telephone follow-up. RESULTS: Forty-two patients (28%) experienced a wide spectrum of CVD with acute myocarditis being the most frequent. Death occurred in 32 patients (21%) and more frequently in patients who developed CVD (p = 0.032). After adjustment for confounders, CVD was independently associated with death occurrence. At one-month follow-up visit, 7 patients (9%) presented persistent or delayed CVD. At one-year telephone follow-up, 57 patients (48%) reported persistent symptoms. CONCLUSION: Cardiovascular evaluation in COVID-19 patients is crucial since the occurrence of CVD in hospitalized COVID-19 patients is common (28%), requires specific treatment and increases the risk of in-hospital mortality. Persistence or delayed presentation of CVD at 1-month (9%) and persistent symptoms at 1-year follow-up (48%) suggest the need for monitoring COVID-19 survivors.
BACKGROUND:Cardiovascular disease (CVD) can occur in COVID-19 and has impact on clinical course. Data on CVD prevalence in hospitalized COVID-19patients and sequelae in survivors is limited. Aim of this prospective study carried out on consecutive unselected COVID-19 population, was to assess: 1) CVD occurrence among hospitalized COVID-19patients, 2) persistence or new onset of CVD at one-month and one-year follow-up. METHODS: Over 30 days n = 152 COVID-19patients underwent cardiovascular evaluation. Standard electrocardiogram (ECG), Troponin and echocardiography were integrated by further tests when indicated. Medical history, arterial blood gas, blood tests, chest computed tomography and treatment were recorded. CVD was defined as the occurrence of a new condition during the hospitalization for COVID-19. Survivors attended a one-month follow-up visit and a one-year telephone follow-up. RESULTS: Forty-two patients (28%) experienced a wide spectrum of CVD with acute myocarditis being the most frequent. Death occurred in 32 patients (21%) and more frequently in patients who developed CVD (p = 0.032). After adjustment for confounders, CVD was independently associated with death occurrence. At one-month follow-up visit, 7 patients (9%) presented persistent or delayed CVD. At one-year telephone follow-up, 57 patients (48%) reported persistent symptoms. CONCLUSION: Cardiovascular evaluation in COVID-19patients is crucial since the occurrence of CVD in hospitalized COVID-19patients is common (28%), requires specific treatment and increases the risk of in-hospital mortality. Persistence or delayed presentation of CVD at 1-month (9%) and persistent symptoms at 1-year follow-up (48%) suggest the need for monitoring COVID-19 survivors.
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