Incidence of Major Adverse Cardiac Events at 6-Months Follow-Up in Covid-19 Positive Versus Covid-19 Negative Patients

Abstract

Background: The post-acute cardiovascular (CV) events due to COVID-19 is a topic of interest. We explored long-term major adverse cardiac events (MACE) related to COVID-19, defined as MI, thromboembolic events (TE), CHF, arrhythmias, and death.

Methods: This is a longitudinal study of COVID-19 positive (CoVP) and negative patients (CoVN) in the first month of the pandemic with at least one follow-up encounter after 6 months. Continuous measures were summarized using means and standard deviation and compared between groups using Student's t-tests. Categorical measures were summarized using count and compared using Fisher's exact test.

Results: Of 2298 patient tests between 3/6/20 and 4/5/20, 394 (50% CoVP, age 57.9±19.4, 49.2% F, and 50% CoVN, age 57.7±18.3, 49.2% F) were selected. Encounters included ED (29.7%) and inpatient (70.3%) visits. Prevalence of preexisting CV risk factors (HTN, HLD, DM, and tobacco use) were similar in CoVP and CoVN (65.5% vs 66.5%, p NS), while CHF (13.7% vs 21.8%, p 0.048), prior MI (8.6% vs 16.2%, p 0.032), and arrhythmias (15.2% vs 24.4%, p 0.031) were more prevalent in CoVN. In the cohort, 48.2% of CoVP and 60.9% of CoVN had a 6-month follow up encounter (p 0.015). The incidence of MACE in CoVP was 27.5%, whereas, in CoVN it was 42.5% (Figure 1).

Conclusion: In a matched cohort of CoVP vs CoVN at the start of the pandemic, 6-month MACE was similar. False negative testing, limited access to healthcare early in the pandemic, and a high rate of comorbidities among CoVN may explain our results.