Aim We evaluated the incidence and relative risk of major post-acute cardiovascular consequences of SARS-CoV-2 infection in a large real-world population from a primary care database in a region at moderate cardiovascular risk followed up in the period 2020-2022. Methods and results This is a retrospective cohort analysis using data from a cooperative of general practitioners in Italy. Individuals aged >18 affected by COVID-19 starting from January 2020 have been followed for three years. Anonymized data from of 228,266 patients in the period 2020-2022 were considered for statistical analysis and included 31,764 subjects with a diagnosis of COVID-19. An equal group of subjects recorded in the same database in the period 2017-2019 was used as propensity score matched comparison as an unquestionable COVID-19 free population. Out of the 228,266 individuals included in the COMEGEN Database during 2020-2022, 31,764 (13.9%) were ascertained positive with SARS-CoV-2 infection by a molecular test reported to general practitioners. The proportion of individuals with a new diagnosis of major adverse cardiovascular and cerebrovascular events was higher in the 2020-2022 COVID-19 group than in the 2017-2019 COMEGEN propensity score matched comparator, with an OR of 1.73 (95% CI: 1.53-1.94; p<0.001). All major adverse cardiovascular and cerebrovascular events considered showed a significantly higher risk in COVID-19 individuals. Incidence calculated for each 6-months period after the diagnosis of COVID-19 in our population was the highest in the first year (1.39 and 1.45% respectively), though it remained significantly higher than in the COVID-19 free patients throughout the three years. Conclusions The increase of cardiovascular risk associated with COVID-19 might be extended for years and not limited to the acute phase of the infection. This should promote the planning of longer follow up for COVID-19 patients to prevent and promptly manage the potential occurrence of major adverse cardiovascular and cerebrovascular events.

中文翻译：

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COVID-19 患者心脑血管事件持续增加：基于人群的 3 年分析

目的 我们通过 2020 年至 2022 年期间随访的中等心血管风险地区的初级保健数据库，评估了大量现实世界人群中 SARS-CoV-2 感染的主要急性后心血管后果的发生率和相对风险。方法和结果这是一项回顾性队列分析，使用了意大利全科医生合作社的数据。自 2020 年 1 月起，对 18 岁以上受 COVID-19 影响的个人进行了为期三年的跟踪。我们考虑对 2020 年至 2022 年期间 228,266 名患者的匿名数据进行统计分析，其中包括 31,764 名诊断为 COVID-19 的受试者。 2017-2019 年期间同一数据库中记录的一组同等受试者被用作倾向评分匹配比较，作为毫无疑问的无 COVID-19 人群。 2020-2022 年期间，COMEGEN 数据库中纳入的 228,266 人中，通过向全科医生报告的分子检测结果，31,764 人（13.9%）被确定为 SARS-CoV-2 感染阳性。 2020-2022 年 COVID-19 组中新诊断出主要不良心脑血管事件的个体比例高于 2017-2019 年 COMEGEN 倾向评分匹配比较组，OR 为 1.73（95% CI：1.53- 1.94；p＜0.001)。所有考虑的主要不良心脑血管事件均显示出 COVID-19 个体的风险显着较高。在我们的人群中诊断出 COVID-19 后，每 6 个月计算出的发病率在第一年最高（分别为 1.39% 和 1.45%），但在整个三年中仍显着高于未患 COVID-19 的患者。结论 与 COVID-19 相关的心血管风险增加可能会持续数年，而不仅限于感染的急性期。这应该促进对 COVID-19 患者进行更长时间的随访，以预防和及时管理重大不良心脑血管事件的潜在发生。