Long COVID and cardiovascular disease: a prospective cohort study

Author:

Lawson Claire AlexandraORCID,Moss Alastair JamesORCID,Arnold Jayanth Ranjit,Bagot CatherineORCID,Banerjee AmitavaORCID,Berry Colin,Greenwood JohnORCID,Hughes Alun D,Khunti Kamlesh,Mills Nicholas L,Neubauer Stefan,Raman Betty,Sattar Naveed,Leavy Olivia C,Richardson Matthew,Elneima Omer,McAuley Hamish JC,Shikotra Aarti,Singapuri Amisha,Sereno Marco,Saunders Ruth,Harris Victoria,Houchen-Wolloff LinzyORCID,Greening Neil J,Harrison Ewen,Docherty Annemarie B,Lone Nazir I,Quint Jennifer KathleenORCID,Chalmers James,Ho Ling-Pei,Horsley Alex,Marks Michael,Poinasamy Krisnah,Evans Rachael,Wain Louise V,Brightling Chris,McCann Gerry PORCID

Abstract

BackgroundPre-existing cardiovascular disease (CVD) or cardiovascular risk factors have been associated with an increased risk of complications following hospitalisation with COVID-19, but their impact on the rate of recovery following discharge is not known.ObjectivesTo determine whether the rate of patient-perceived recovery following hospitalisation with COVID-19 was affected by the presence of CVD or cardiovascular risk factors.MethodsIn a multicentre prospective cohort study, patients were recruited following discharge from the hospital with COVID-19 undertaking two comprehensive assessments at 5 months and 12 months. Patients were stratified by the presence of either CVD or cardiovascular risk factors prior to hospitalisation with COVID-19 and compared with controls with neither. Full recovery was determined by the response to a patient-perceived evaluation of full recovery from COVID-19 in the context of physical, physiological and cognitive determinants of health.ResultsFrom a total population of 2545 patients (38.8% women), 472 (18.5%) and 1355 (53.2%) had CVD or cardiovascular risk factors, respectively. Compared with controls (n=718), patients with CVD and cardiovascular risk factors were older and more likely to have had severe COVID-19. Full recovery was significantly lower at 12 months in patients with CVD (adjusted OR (aOR) 0.62, 95% CI 0.43 to 0.89) and cardiovascular risk factors (aOR 0.66, 95% CI 0.50 to 0.86).ConclusionPatients with CVD or cardiovascular risk factors had a delayed recovery at 12 months following hospitalisation with COVID-19. Targeted interventions to reduce the impact of COVID-19 in patients with cardiovascular disease remain an unmet need.Trail registration numberISRCTN10980107.

Funder

NIHR Leicester Biomedical Research Centre

National Institute for Health Research

Chief Scientist Office

British Heart Foundation

Publisher

BMJ

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1. Long COVID science, research and policy;Nature Medicine;2024-08

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