Risk of incident heart failure after COVID-19 recovery: a systematic review and meta-analysis

Abstract

Patients recovered from COVID-19 have an increased incidence of cardiovascular disease and heart structural changes. The aim of the present manuscript is to assess the risk of incident heart failure (HF) after COVID-19 infection. Data were obtained searching MEDLINE and Scopus for all studies published at any time up to September 1, 2022 reporting the risk of incident HF in COVID-19 recovered patients. The cumulative post-COVID-19 incidence and risk of incident HF were pooled using a random effects model and presented with the corresponding 95% confidence interval (CI). Statistical heterogeneity was measured using the Higgins I 2 statistic. Overall, 21,463,173 patients (mean age 54.5 years, 58.7% males) were analyzed. Among them, 1,628,424 had confirmed COVID-19 infection while the remaining 19,834,749 represented the controls. The mean length of follow-up was 9.2 months. A random effect model revealed a pooled incidence of post COVID-19 HF in 1.1% of cases (95% CI: 0.7–1.6, I 2 : 99.8%). Moreover, recovered COVID-19 patients showed an increased risk of incident HF (HR: 1.90, 95% CI: 1.54–3.24, p < 0.0001, I 2 = 96.5%) in the same follow-up period. Meta-regression showed a direct relationship for the risk of incident HF using age ( p = 0.001) and hypertension (HT) ( p = 0.02) as moderators, while an inverse association was observed when the follow-up length was adopted as moderating variable ( p = 0.01). COVID-19 survivors had an additional 90% risk of developing HF after COVID-19 infection in the long-term period. This risk was directly related with age and previous history of HT especially in the early post-acute phase of the infection. Supplementary Information The online version contains supplementary material available at 10.1007/s10741-022-10292-0.

Risk of incident pericarditis after coronavirus disease 2019 recovery: a systematic review and meta-analysis

“…The different therapeutic approaches, related to the severity of the infection, may have influenced the patient's immunosuppression and as a consequence the cytocidal effect of the virus on cardiac muscle, which has a critical role in the genesis of pericarditis. 4,28 Previous studies have also recognized pericarditis as a rare complication of COVID-19 mRNA vaccinations, especially in young adults and adolescents, with an estimated incidence of about 1.8 cases per 100 000 people. 25 However, the incidence after mRNA vaccinations was lower compared with that observed in the long-term recovery period, evidencing a net clinical benefit for COVID-19 immunization.…”

“…Over the latest year, a growing body of evidence has demonstrated an increased risk of cardiovascular sequelae after coronavirus disease 2019 (COVID-19) recovery compared with the general population not exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. [1][2][3][4][5][6] The precise pathophysiological mechanisms underlying these heterogeneous clinical manifestations remain largely unknown; however, a primary role seems to be due to persistent inflammation and catabolic state as well as reactivation of latent virus, renin-angiotensin-aldosterone system (RAAS) dysregulation and deep cardiovascular deconditioning. 7,8 Although previous analyses have reported the occurrence of acute pericarditis either during the acute phase of the disease or as a complication of vaccination against COVID-19 disease, [9][10][11][12][13][14] data regarding the risk of pericarditis as postacute COVID-19 sequelae remain scant.…”

“…Over the latest year, a growing body of evidence has demonstrated an increased risk of cardiovascular sequelae after coronavirus disease 2019 (COVID-19) recovery compared with the general population not exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection 1–6 . The precise pathophysiological mechanisms underlying these heterogeneous clinical manifestations remain largely unknown; however, a primary role seems to be due to persistent inflammation and catabolic state as well as reactivation of latent virus, renin–angiotensin–aldosterone system (RAAS) dysregulation and deep cardiovascular deconditioning 7,8 .…”

Prevalence and characteristics of newly diagnosed heart failure in patients with shortness of breath after coronavirus infection

“…Диагностика ХСН в отдаленный период после COVID-19 во всех наблюдательных исследованиях проводилась лишь по клиническим симптомам, таким как одышка, сердцебиение при нагрузке, утомляемость, мышечная слабость, которые типичны как для недостаточности кровообращения, так и постковидного синдрома без данной патологии, что затрудняет верификацию ХСН и, возможно, является причиной "гиподиагностики" недостаточности кровообращения [3].…”

Risk of Incident New-Onset Arterial Hypertension After COVID-19 Recovery: A Systematic Review and Meta-analysis

“…Since the beginning of COVID-19 outbreak, arterial hypertension (HT) was recognized as one of the most common comorbidities in COVID-19 patients as well as an independent predictor of short-term mortality and severe disease [1][2][3][4]. Recent analyses have demonstrated an increased risk of cardiovascular sequelae after COVID-19 recovery compared to the general population not exposed to SARS-CoV-2 infection [5][6][7][8][9]. However, data regarding the risk of development new-onset HT as a post-acute COVID-19 sequelae remain scant.…”