Farzad Jalali
1 
, Farbod Hatami
2 , Mehrdad Saravi
1 , Iraj Jafaripour
1 , Mohammad Taghi Hedayati
1 , Kamyar Amin
1 , Roghayeh Pourkia
1 , Saeid Abroutan
1, Mostafa Javanian
3 , Soheil Ebrahimpour
3 , Niloufar Valizadeh
2 , Saeede Khosravi Bizhaem
2,4 , Naghmeh Ziaie
1* 1 Department of Cardiology, Babol University of Medical Sciences, Babol, Iran
2 Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
3 Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
4 Clinical Research Development Unit, Razi Hospital, Birjand University of Medical Sciences, Birjand, Iran
Abstract
Introduction: To address cardiovascular (CV) complications and their relationship to clinical outcomes in hospitalized patients with COVID-19.
Methods: A total of 196 hospitalized patients with COVID-19 were enrolled in this retrospective single-center cohort study from September 10, 2020, to December 10, 2020, with a median age of 65 years (IQR, 52-77). Follow-up continued for 3 months after hospital discharge.
Results: CV complication was observed in 54 (27.6%) patients, with arrhythmia being the most prevalent (14.8%) followed by myocarditis, acute coronary syndromes, ST-elevation myocardial infarction, cerebrovascular accident, and deep vein thrombosis in 15 (7.7%), 12 (6.1%), 10(5.1%), 8 (4.1%), and 4 (2%) patients, respectively. The proportion of patients with elevated high-sensitivity troponin I, N-terminal pro-B-type natriuretic peptide, left ventricular diastolic dysfunction, and heart failure with preserved ejection fraction was greater in the CV complication group. Severe forms of COVID-19 comprised nearly two-thirds (64.3%) of our study population and constituted a significantly higher share of the CV complication group members (75.9%vs 59.9%; P=0.036). Intensive care unit admission (64.8% vs 44.4%; P=0.011) and stay (5.5days vs 0 day; P=0.032) were notably higher in patients with CV complications. Among 196patients, 50 died during hospitalization and 10 died after discharge, yielding all-cause mortality of 30.8%. However, there were no between-group differences concerning mortality. Age, heart failure, cancer/autoimmune disease, disease severity, interferon beta-1a, and arrhythmia were the independent predictors of all-cause mortality during and after hospitalization.
Conclusion: CV complications occurred widely among COVID-19 patients. Moreover,arrhythmia, as the most common complication, was associated with increased mortality.