What is the relationship between COVID-19, cardiovascular disease, and mortality?

In a recent study published in cardiovascular researchresearchers evaluated the association between COVID-19 (coronavirus disease 2019) and CVD (cardiovascular disease) and/or death.

Background

CVD symptoms have been reported in a significant proportion of COVID-19 patients, indicating cardiac structural and functional abnormalities such as myocardial damage and elevated cardiac tissue troponin levels. A better understanding of the cardiovascular outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may help identify high-risk patients and provide tailored treatments to improve standard of care there is.

About research

In the current study, researchers investigated cardiac symptoms in patients with COVID-19 and those with longer duration of COVID-19.

The team identified a SARS-CoV-2 positive case from the United Kingdom (UK) Biobank database between 16 March 2020 and 30 November 2020, followed for 18.0 months until 31 August 2021 . Based on gender and age, COVID-19 cases were divided into a historical group from March 16, 2018 to November 30, 2018, and a contemporary group from March 16, 2018 to November 30, 2020. of ≤10 individuals lacking SARS-CoV-2 infection. , 2020.

The team performed propensity score matching and MMWS (marginal mean weighting with stratification) for gender, age, body mass index, ethnicity, smoking, hypertension, diabetes, Charlson comorbidity index, hypertension, multiple deprivation indices, and prior medical history. ) to adjust individual characteristics. COVID-19 results. Cox proportional hazards regression modeling was performed to assess the association between the onset of cardiovascular disease and death within his 3.0 weeks of diagnosis (acute phase) and in the subsequent period of acute COVID-19, yielding a hazard ratio (HR ) was calculated.

COVID-19 severity was based on data on critical care hospital admissions and the type of medical support provided to each SARS-CoV-2-positive individual. Participant data provided by the UK Biobank were linked to primary care (GP level) data through the Phoenix Partnership in the UK and his Egton medical data system until 31 August 2021. rice field.

In addition, data on inpatients and death records provided by the NHS (National Health Service) Digital Public Health in Scotland were linked to data provided by the National Health Service in Wales, Scotland, and England for study participants. rice field. The diagnosis of COVID-19 was based on a positive PCR (polymerase chain reaction) analysis report or the International Classification of Diseases10.^th Revision for COVID-19 Related Diagnosis (ICD-10) admission codes U07.1 and U07.2. Subgroup analyzes were performed to assess cardiovascular and mortality risks based on COVID-19 severity and individual gender.

result

During the acute phase, a cohort of 7,584 SARS-CoV-2-positive individuals, compared with 75,790 contemporary controls and 75,774 historical controls, had cardiovascular disease (HR 4.30; HR 5.00) and any Death from cause (HR: 81; HR: 68), respectively in the short term. During the period following the acute infection period of SARS-CoV-2, a cohort of 7,139 COVID-19 patients had long-term cardiovascular disease (HR 1.40; HR 1.30) and death from any cause (HR: 5.00; HR 4.50) compared with 71,296 contemporary controls and 71,314 historical controls, respectively.

The incidence of acute phase SARS-CoV-2 infection-related deaths was 700. Of note is the risk of DVT (deep vein thrombosis), AF (atrial fibrillation), and stroke in the contemporary group (stroke: 10; AF: 8.0; DVT: 22) and the historical group (stroke: 5.0; AF: 6.0; DVT: 11). During the period following the acute COVID-19 outbreak, the incidence of deaths associated with SARS-CoV-2 infection was 12. Of note, unlike the acute phase, acute post-COVID-19 patients had pericarditis compared with contemporary controls (HR 4.6) and historical controls (HR 4.50).

Subgroup analyzes showed that patients with severe COVID-19 were more likely to develop major cardiovascular disease and more likely to die from any cause compared with non-severe COVID-19 cases. showed that male sex was associated with a higher risk of developing cardiovascular disease. Acute phase of COVID-19. However, during the post-acute period, cardiovascular risk was nearly equal between men and women.

Mechanisms that may explain the pathophysiology of the long COVID heart include the direct effects of SARS-CoV-2 and angiotensin-converting enzyme 2 (ACE2) receptor binding, which is critical for SARS-CoV-2 entry. included. This is because the receptor is present in heart tissue, including the cardiovascular system. SARS-CoV-2 can directly infect cardiomyocytes and other cardiac cells, which is consistent with previously published histopathological findings of markedly elevated macrophage infiltration in myocardial tissue. backed by

Overall, the study results showed that SARS-CoV-2 infection and prolonged COVID increase the risk of developing cardiovascular disease and death in the short and long term. This finding suggests that regular monitoring of cardiovascular disease-related clinical symptoms from COVID-19 recovery to recovery within 1 year may be useful in patients with SARS-CoV-2 infection, especially those with severe COVID-19. It shows that it can benefit men.