New Cardiovascular Diagnoses, Symptoms and Functional Status Following SARS-CoV-2 Infection in a National Cohort of 1,734 Patients in Italy.

BACKGROUND: Few clinical studies have assessed cardiovascular events and associated symptoms following coronavirus disease 2019 (COVID-19). METHOD: This was a multicentre study of patients with previous severe acute respiratory syndrome coronavirus 2 infection followed at university and hospital clinics, with collection of both retrospective and prospective data. Demographics, comorbidities, severity and timing of acute COVID-19, subjective functional status, and presence of 30 symptoms were collected. New diagnoses following COVID-19 were classified as cardiovascular or non-cardiovascular. The associations between clinical and demographic covariates and occurrence of new diagnoses were assessed in multivariable logistic regression models. RESULTS: New diagnoses were made in 40.5% of 1,734 adult patients (non-cardiovascular, 35.1%; cardiovascular, 10.9%; both types, 5.4%). The most common new cardiovascular diagnoses were arrhythmias (3.0%), pulmonary embolism (2.6%), hypertension (2.4%), and pericarditis (2.0%), followed by heart failure and venous thrombosis (both at 1.3%), myocarditis (0.6%), and ischaemic heart disease (0.3%). In the multivariable analyses, new cardiovascular diagnoses were associated with age >65 years (adjusted odds ratio 1.64; 95% confidence interval 1.15-2.33), admission to the intensive care unit during acute infection (1.85; 1.08-3.17), and chronic pulmonary disease (1.76; 1.02-3.06). After a mean follow-up of 7 months, patients with new cardiovascular diagnoses had a significantly higher mean number of symptoms, significantly higher prevalence of several individual symptoms, and worse functional status compared with pre-infection. CONCLUSIONS: The findings suggest that new cardiovascular diagnoses following COVID-19 significantly affect subsequent wellbeing. Preventing their occurrence may reduce not only acute and post-acute cardiovascular morbidity, but also the persistence, breadth, and burden of post-COVID-19 symptoms, and may avert a significant decline in functional status.