Cardiovascular complications in the course of COVID-19 - lessons learned and implications for the future care of patients with viral respiratory diseases: Data from a single center retrospective observational study

Abstract

Background

Factors associated with cardiovascular complications of COVID-19 remain understudied.

Objectives

Here we investigate the occurrence and risk factors of arrythmias, myocardial infarction and/or stroke, and thromboembolism in the course of COVID-19.

Methods

We have performed an observational study with prospectively designed data collection. Data of patients diagnosed with COVID-19 who were admitted from March 6th 2020 to November 30th 2021 in our Hospital were analyzed. Logistic regression was used to identify variables associated with the odds of early hospital death due to COVID-19.

Results

Fourteen-point three percent of 1964 patients had cardiovascular complications, 6.36 % arrhythmias, 5.5 % thromboembolic events and 2.39 % myocardial infarction and/or stroke. Factors independently increasing the odds of arrhythmia were older age (OR=1.49 [95 % CI: 1.17–1.92], p = 0.02), longer time between admission and the first onset of symptoms (1.02 [0.99–1.05], p = 0.049), concomitant atrial fibrillation/flutter (2.84 [1.37–5.70], p = 0.004), nicotinism (2.49 [1.37–4.49], p = 0.002), and eGFR<60 ml/min/1.73m² (2.44 [1.08–5.59], p = 0.033). Factors independently increasing the odds of myocardial infarction and/or stroke were dementia (4.55 [0.97–19.3], p = 0.044), hemiplegia (12.67 [3.12–46.1], p < 0.001), nicotinism (3.36 [1.30–10.4], p = 0.013) and higher C-reactive protein concentration (1.01 [1.00–1.01], p = 0.040). Factors independently increasing the odds of thromboembolic events were longer hospitalization (1.08 [1.05–1.10], p < 0.001) and higher d-dimers (1.04 [1.02–1.05], <0.001).

Conclusions

The risk of cardiovascular complications was especially pronounced in patients with older age, pre-existing cardiovascular disease and more sever pneumonia at presentation to care. This underlines the importance of close and careful clinical follow-up in the course of COVID-19 for specific patients’ populations, including a pro-active approach in diagnosis.