Long COVID and cardiovascular disease: a prospective cohort study.
Lawson CA., Moss AJ., Arnold JR., Bagot C., Banerjee A., Berry C., Greenwood J., Hughes AD., Khunti K., Mills NL., Neubauer S., Raman B., Sattar N., Leavy OC., Richardson M., Elneima O., McAuley HJ., Shikotra A., Singapuri A., Sereno M., Saunders R., Harris V., Houchen-Wolloff L., Greening NJ., Harrison E., Docherty AB., Lone NI., Quint JK., Chalmers J., Ho L-P., Horsley A., Marks M., Poinasamy K., Evans R., Wain LV., Brightling C., McCann GP., PHOSP-COVID Study Collaborative Group None.
BACKGROUND: Pre-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. OBJECTIVES: To determine whether the rate of patient-perceived recovery following hospitalisation with COVID-19 was affected by the presence of CVD or cardiovascular risk factors. METHODS: In 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. RESULTS: From 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). CONCLUSION: Patients 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 NUMBER: ISRCTN10980107.