Aim. To characterize patients admitted to hospital with suspected or documented COVID-19 infection and community-acquired pneumonia (CAP) and to assess the prevalence of concomitant cardiovascular, non-cardiac diseases, prehospital cardiovascular therapy and outcomes of in-hospital treatment. Material and methods. The TARGET-VIP registry includes patients admitted to the N. I. Pirogov National Medical and Surgical Center with suspected or documented COVID-19 infection and/or CAP for the period from April 6, 2020 to July 2, 2020. COVID-19 infection was diagnosed using polymerase chain reaction (PCR) tests and chest computed tomography (CT). Comorbid conditions and pre-hospital therapy were assessed. Results. A total of 1, 130 patients were included in the registry (mean age, 57,5±12,8 years; men, 579 (51,2%)). Using PCR test, COVID-19 infection was established in 686 (60,7%) patients; using chest CT -334 (29,6%) patients. The most numerous were the group with a combination of COVID-19 and CAP (n=662; 58,6%) and the group with CAP without positive PCR (n=402; 35,6%). The group of patients with COVID-19 without CAP was the smallest (n=24; 2, 1%); in 3,7% of patients (n=42), CAP was not confirmed and PCR were negative. The proportion of people with cardiovascular diseases (CVD) according to the survey, in comparison with data of medical records, was higher by 2% (52,2 vs 50,2%); the proportion of persons with chronic non-cardiac diseases -higher by 6,7% (50,8 vs 44, 1%). Among patients with CVD (n=598), compared with patients without CVD (n=532), following diseases was diagnosed significantly more often: diabetes (odds ratio (
Aim. According to hospital-based registry, to evaluate the age characteristics and prevalence of concomitant cardiovascular and non-сardiovascular diseases in patients hospitalized with COVID-19 during epidemic wave.Material and methods. The TARGET-VIP register included 1130 patients aged 57,5+12,8 years (men, 51,2%) hospitalized at the Pirogov National Medical and Surgical Center from April 6, 2020 to June 22, 2020 with COVID-19. Cardiovascular diseases (CVDs) were diagnosed in 51,6% of patients, non-сardiovascular chronic diseases — in 48,6%, while CVDs and/or non-сardiovascular chronic diseases — in 65,8% of patients.Results. The average age of patients significantly increased by an average of 0,77 years per week (p<0,001), while the difference between the 1st week (52,8 years) and 11th week (62,2 years) was 9,4 years; the proportion of men did not change significantly. The proportion of patients with CVDs increased significantly — from 34,2% to 66,7%, on average by 3,7% per week (p<0,001; Incidence Risk Ratio (IRR)=1,037; 95% confidence interval (CI), 1,017-1,058), with chronic non-cardiovascular diseases — from 32,5% to 43,2%, on average by 2,5% per week (p<0,001; IRR=1,025; 95% CI, 1,002-1,049), as well as those with CVDs and/or chronic non-cardiovascular diseases — from 47,5% to 75,3%, on average by 3,2% per week (p<0,001; IRR=1,032; 95% CI, 1,017-1,048). Over the entire period, the proportion of people with hypertension (HTN) was 47,0%, with coronary artery disease (CAD) — 15,4%, with heart failure (HF) — 4,0%, and with atrial fibrillation (AF) — 10,1%. The proportion of patients with HTN increased by 9,5% (p<0,001; OR=1,095; 95% CI, 1,047-1,144), with СAD — by 9,4% (p=0,01; OR=1,094; 95% CI, 1,022-1,172) and with AF — by 9,4% (p<0,001; OR=1,094; 95% CI, 1,023-1,170) per week. The proportion of patients with diabetes was 16,5%, with respiratory diseases — 11,4%, with chronic kidney disease (CKD) — 12,6%, with digestive diseases — 22,5%, with obesity — 6,1%. During the epidemic wave, the most pronounced increase in the proportion of patients with CKD was by 6,2% (p=0,036; OR=1,062; 95% CI, 1,004-1,124) and with digestive diseases — by 6,0% (p=0,01; OR=1,060; 95% CI, 1,014-1,109) per week.Conclusion. According to the 11-week TARGET-VIP registry, the age of patients increased by 9,4 years, CVD cases — by 1,9 times (mainly HTN, CAD, AF), and chronic nonсardiovascular pathology — by 1,3 times (mainly CKD and digestive diseases). These trends in hospital practice corresponded to a weekly increase in the proportion of patients with a higher risk of fatal and non-fatal complications, which is the basis for further research in order to develop a system for a comprehensive prognostic assessment of the degree and rate of increase in the load on hospitals during COVID-19 epidemic wave.
Aim. To study the clinical and anamnestic characteristics, pharmacotherapy of cardiovascular diseases (CVD) and long-term outcomes in post-COVID-19 patients with cardiovascular multimorbidity (CVMM), enrolled in the prospective hospital registry.Material and methods. In patients with confirmed COVID-19 included in the TARGET-VIP registry, the CVMM criterion was the presence of two or more CVDs: arterial hypertension (AH), coronary heart disease (CHD), chronic heart failure (CHF), atrial fibrillation (AF). There were 163 patients in the CVMM group and 382 – in the group without CVD. The information was obtained initially from hospital history sheet, and afterwards – from a telephone survey of patients after 30-60 days, 6 and 12 months, from electronic databases. The follow-up period was 13.0±1.5 months.Results. The age of post-COVID patients with CVMM was 73.7±9.6 years, without CVD – 49.4±12.4 years (p<0.001), the proportion of men was 53.9% and 58.4% (p=0.34). In the group with CVMM the majority of patients had AH (92.3-93.3%), CHD (90.4-91.4%), and minority – CHF (42.7-46.0%) and AF (42.9-43.4%). The combination of 3-4 CVDs prevailed (58.9-60.3%). The proportion of cases of chronic non-cardiac pathologies was higher in the CVMM group (80.9%) compared to the group without CVD (36.7%; p<0.001). The frequency of proper cardiovascular pharmacotherapy during the follow-up period decreased from 56.8% to 51.3% (p for trend = 0.18). The frequency of anticoagulant therapy in AF decreased significantly: from 89.1% at the discharge from the hospital to 56.4% after 30-60 days (p=0.001), 57.1% and 53.6% after 6 and 12 months of monitoring (p for a trend <0.001). There were no other significant changes in the frequency of other kinds of the proper cardiovascular pharmacotherapy (p>0.05). There were higher rate of all-cause mortality among patients with CMMM (12.9% vs 2.9%, p<0.001) as well as rates of hospitalization (34.7% and 9.9%, p<0.001) and non-fatal myocardial infarction (MI) – 2.5% vs 0.5% (p=0.048). The proportion of new cases of CVD in the groups with CVMM and without CVD was 5.5% and 3.7% (p=0.33). The incidence of acute respiratory viral infection (ARVI)/influenza was higher in the group without CVD – 28.3% vs 19.0% (p=0.02). The proportion of cases of recurrent COVID-19 in groups with CVMM and without CVD was 3.7 % and 1.8% (p=0.19).Conclusion. Post COVID-19 patients with CVMM were older and had the bigger number of chronic non-cardiac diseases than patients without CVD. The quality of cardiovascular pharmacotherapy in patients with CVMM was insufficient at the discharge from the hospital with following non-significant decrease during 12 months of follow-up. The frequency of anticoagulant therapy in AF decreased by 1.6 times after 30-60 days and by 1.7 times during the year of follow-up. The proportion of new cases of CVD was 5.5% and 3.7% with no significant differences between compared groups. The rate of all-cause mortality, hospitalizations and non-fatal MI was significantly higher in patients with CVMM, but the frequency of ARVI/influenza was significantly higher in patients without CVD. Recurrent COVID-19 was registered in 3.7% and 1.8% of cases, there were no significant differences between compared groups.
Aim. To assess long-term outcomes within 12 months after hospital treatment of patients with coronavirus disease 2019 (COVID-19) as part of a prospective registry.Material and methods. Outcomes in the posthospital period were assessed in 827 patients diagnosed with COVID-19 (age, 58,0±14,8 years; men, 51,3%). For periods of 30-60 days, 6 and 12 months after discharge from the hospital, cases of death, nonfatal myocardial infarction (MI) and stroke, hospitalization, acute respiratory viral infections/influenza were assessed. The follow-up period was 13,0±1,5 months.Results. During the follow-up period, 35 (4,2%) patients died, 6 (0,73%) and 4 (0,48%) cases of MI and stroke were registered. In addition, 142 (17%) patients were hospitalized, while 217 (26,2%) patients had acute respiratory viral infections/ influenza. Factors of age and length of intensive care unit stay were significantly associated (p<0,001) with the risk of all-cause death (hazard ratio (HR)=1,085 per 1 year of life and HR=6,98, respectively), with the risk of composite endpoint (death, non-fatal MI and stroke): HR=1,081 per 1 year of life and HP=4,47. Of the 35 deaths, 11 (31%) were within the first 30 days of follow-up, and 19 (54%) — 90 days after discharge from the hospital. A higher probability of hospitalization was associated with older age (odds ratio (OR)=1,038; p<0,001), while a higher probability of acute respiratory viral infections/influenza was associated with younger age (OR=0,976 per 1 year of life; p<0,001) and female sex (OR=1,414; p=0,03).Conclusion. A prospective follow-up of 827 patients in the TARGET-VIP registry revealed that 12-month mortality was 4,2%, while more than half of the deaths (54%) were registered in the first 90 days, including 31% — for the first month after discharge from the hospital. The most common events were hospitalizations (17,0%) and acute respiratory viral infections/influenza (26,2%), while the rarest were myocardial infarction (0,73%) and stroke (0,48%). The key factors associated with 12-month mortality in the post-COVID-19 period were older age and intensive care unit stay during the reference hospitalization. A higher readmission rate during the follow-up period was associated with older age, and the prevalence of acute respiratory viral infections /influenza during the follow-up period was associated with younger patients and female sex.
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