Hospitalized COVID-19 Patients Still Face Cardiovascular Challenges after Discharge, Study Finds

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Coronavirus disease 2019 (COVID-19) patients who are discharged from the hospital still face a heightened risk of experiencing a major adverse cardiovascular event (MACE), according to new research from the United Kingdom.

“With over 3 million people in the UK having tested positive for COVID-19 at the time of writing, and many more who had the disease but never received a test, our findings suggest that the long-term burden of COVID-related morbidity on hospitals and broader healthcare systems is likely to be substantial,” wrote authors led by Daniel Ayoubkhani, principal statistician, Office for National Statistics, Newport, UK.

Researchers examined data from 47 780 hospitalized COVID-19 patients (mean age, 65 years; 55% men) who were discharged by August 31, 2020. COVID-19 patients were then matched with controls who had been hospitalized from January 2019 to September 2020 and did not receive a COVID-19 diagnosis.

The mean follow-up time was 140 days for the COVID-19 cohort and 153 days for the control cohort.

Overall, there were 766 (95% confidence interval [CI]: 753-779) readmissions and 320 (95% CI: 312-328) deaths per 1000 person-years observed in the COVID-19 group, 3.5- and 7.7-times greater, respectively, vs controls.

The MACE rate was “significantly elevated” for COVID-19 patients vs controls (126.1/1000 person-years [95% CI: 121-131.4] vs 42.6/1000 person-years [95% CI: 39.8-45.5]). The rates of diabetes and respiratory events also increased in the COVID-19 group vs controls.

Also, post-discharge adverse events were more common for white participants and those aged ≥70 years—however, when researchers examined adverse events that might be expected to occur in these groups, “younger and ethnic minority individuals faced greater relative risks than those aged ≥70 years and those in the White group, respectively,” wrote authors.

“Individuals discharged from hospital following acute COVID-19 face elevated rates of mortality, readmission and multi-organ dysfunction compared with the background levels that exist for these individuals, and the relative increase in risk is neither confined to the elderly nor uniform across ethnic groups,” concluded authors. “Urgent research is required to further understand the risk factors for PCS [post-COVID syndrome], so that treatment provision can be better targeted to demographically and clinically at-risk populations.”

The study, titled Epidemiology of post-COVID syndrome following hospitalisation with coronavirus: A retrospective cohort study, is published on the medRxiv server while it awaits peer review.

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