Sistema de Salut de Catalunya
Institut Català de la Salut
[Reyes LF] Universidad de La Sabana, Chía, Colombia. Clínica Universidad de La Sabana, Cundinamarca, Colombia. Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom. [Garcia-Gallo E] Universidad de La Sabana, Chía, Colombia. Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom. [Murthy S] Department of Pediatrics, University of British Columbia, Vancouver, Canada. [Fuentes YV] Universidad de La Sabana, Chía, Colombia. [Serrano CC, Ibáñez-Prada ED] Universidad de La Sabana, Chía, Colombia. Clínica Universidad de La Sabana, Cundinamarca, Colombia. [Rello J] Grup de Recerca Clínica/Innovació en la Pneumònia i Sèpsia (CRIPS), Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain. Centro de Investigación Biomédica En Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
Vall d'Hebron Barcelona Hospital Campus
2023-05-15T12:04:23Z
2023-05-15T12:04:23Z
2023-10
COVID-19; Complications; Mortality
COVID-19; Complicacions; Mortalitat
COVID-19; Complicaciones; Mortalidad
Purpose To determine its cumulative incidence, identify the risk factors associated with Major Adverse Cardiovascular Events (MACE) development, and its impact clinical outcomes. Materials and methods This multinational, multicentre, prospective cohort study from the ISARIC database. We used bivariate and multivariate logistic regressions to explore the risk factors related to MACE development and determine its impact on 28-day and 90-day mortality. Results 49,479 patients were included. Most were male 63.5% (31,441/49,479) and from high-income countries (84.4% [42,774/49,479]); however, >6000 patients were registered in low-and-middle-income countries. MACE cumulative incidence during their hospital stay was 17.8% (8829/49,479). The main risk factors independently associated with the development of MACE were older age, chronic kidney disease or cardiovascular disease, smoking history, and requirement of vasopressors or invasive mechanical ventilation at admission. The overall 28-day and 90-day mortality were higher among patients who developed MACE than those who did not (63.1% [5573/8829] vs. 35.6% [14,487/40,650] p < 0.001; 69.9% [6169/8829] vs. 37.8% [15,372/40,650] p < 0.001, respectively). After adjusting for confounders, MACE remained independently associated with higher 28-day and 90-day mortality (Odds Ratio [95% CI], 1.36 [1.33–1.39];1.47 [1.43–1.50], respectively). Conclusions Patients with severe COVID-19 frequently develop MACE, which is independently associated with worse clinical outcomes.
Article
Published version
English
Sistema cardiovascular - Malalties - Factors de risc; COVID-19 (Malaltia) - Complicacions; DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections; Other subheadings::Other subheadings::Other subheadings::/complications; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors; DISEASES::Cardiovascular Diseases; ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus; Otros calificadores::Otros calificadores::Otros calificadores::/complicaciones; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::estadística como asunto::probabilidad::riesgo::factores de riesgo; ENFERMEDADES::enfermedades cardiovasculares
Elsevier
Journal of Critical Care;77
https://doi.org/10.1016/j.jcrc.2023.154318
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
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