Global cardiovascular risk, COVID-19 severity and post-COVID-19 syndrome: a clinical study

V. Zaccone, L. Falsetti, L. Santoro, E. Guerrieri, S. Santini, G. Viticchi, M. Tosato, M. Danese, C. Miro, S. Cataldi, A. Gasbarrini, F. Landi, A. Santoliquido, G. Moroncini, on Behalf of Gemelli Against Covid-Post-Acute Care Study Group

Internal and Subintensive Medicine Department, Azienda Ospedaliera delle Marche, Ancona, Italy. luca.santoro@policlinicogemelli.it

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• Cardiovascular Diseases
• Infectious Diseases

OBJECTIVE: Post-COVID-19 is a syndrome defined by signs and symptoms present until 12 weeks after COVID-19, lasting for more than 8 weeks, not explained by an alternative diagnosis. The present study aimed to assess whether the cardiovascular risk (CVR) of patients with COVID-19 correlates with symptoms and changes in respiratory function parameters in post-COVID-19. The association between CVR and the severity of acute disease was also considered.

PATIENTS AND METHODS: Between 21/04/21-01/09/21, we enrolled 1,782 consecutive patients with COVID-19. We divided these subjects into (i) 4 levels, based on the severity of COVID-19 (home care; hospitalized/no oxygen therapy; hospitalized/oxygen therapy; hospitalized/NIV-ICU), (ii) 2 levels, according to CVR calculated with the European Society of Cardiology SCORE tables (low-intermediate risk; high or very high risk). All subjects underwent a 3-month follow-up considering post-COVID-19 symptoms.

RESULTS: In post-COVID-19 patients, high or very-high CVR was associated with (i) increased risk of hospitalization for COVID-19 (p<0.0001), (ii) higher prevalence of severe clinical manifestations and ICU admission (p<0.0001), (iii) development of post-COVID-19 (p<0.0001) and (iv) increased risk of a larger post-COVID-19 burden of disease.

CONCLUSIONS: We found a statistically significant association between CVR, severity of COVID-19, and post-COVID-19 syndrome three months after the end of acute disease.

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