More than 1 in 10 hospitalized COVID-19 patients had cardiac event, 2021 study finds
An analysis of 8,460 patients hospitalized with COVID-19 in January to November 2021 also found that 23.4% of those with underlying cardiac disease experienced an acute cardiac event during their admission, as did 6.2% of those without pre-existing cardiac disease.
More than one in 10 patients hospitalized with COVID-19 in 2021 experienced an acute cardiac event, a recent study found.
The retrospective study used medical chart abstraction to look at a sample of adults hospitalized with laboratory-confirmed SARS-CoV-2 infection in 14 U.S. states in January 2021 to November 2021. Researchers calculated the prevalence of acute cardiac events by history of underlying cardiac disease and examined associated risk factors and disease outcomes. Results were published by the Journal of the American College of Cardiology on Feb. 6.
Of the 8,460 hospitalized COVID-19 patients, 11.4% (95% CI, 10.1% to 12.9%) experienced an acute cardiac event during their admission. Event prevalence was higher in those with underlying cardiac disease (23.4%; 95% CI, 20.7% to 26.3%) than in those without (6.2%; 95% CI, 5.1% to 7.6%). The most common events were acute ischemic heart disease (5.5%; 95% CI, 4.5% to 6.5%) and acute heart failure (5.4%; 95% CI, 4.4% to 6.6%). Only 0.3% of patients (95% CI, 0.1% to 0.5%) developed acute myocarditis or pericarditis. Patients with an acute cardiac event were more likely to be admitted to the ICU (adjusted risk ratio [aRR], 1.9; 95% CI, 1.8 to 2.1) or die in the hospital (aRR, 1.7; 95% CI, 1.3 to 2.1) than COVID-19 patients without an event.
“Although this study cannot causally attribute severe in-hospital disease outcomes to acute cardiac events, these results highlight the morbidity and mortality associated of such events in the context of COVID-19,” said the study authors. They noted that the prevalence of acute cardiac events, overall and of specific types, in this study was within a percentage point of that found in inpatients with flu in a previous study.
Based on the results, the authors recommended that clinicians conduct a thorough history and physical evaluation in inpatients with COVID-19 and monitor them for evidence of cardiac complications, including cardiac arrhythmias and cardiogenic shock, throughout hospitalization. “Additionally, all patients and especially those with underlying cardiac disease, should receive recommended outpatient and inpatient COVID-19 treatments expected to have the highest net clinical benefit based on a thorough assessment with their clinicians of the potential benefits, risks, and side effects of any intervention,” they wrote.
An accompanying editorial cautioned that the “data narrowly examine patients ill enough to be hospitalized with or for COVID-19 during the early waves of the pandemic, and may not generalize to ambulatory patients or those infected with less virulent strains of SARS-CoV-2” but said that the results support renewed emphasis on preventing cardiac events in patients with COVID-19. “Effective treatment and control of hypertension and other cardiometabolic risk factors as well as guideline-directed management of underlying [cardiovascular disease] and acute cardiac complications during COVID-19 hospitalization remain critical alongside primary management of COVID-19,” the editorialists wrote.
